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在接受非心脏手术的患者中使用β抑制剂:系统性审查和元分析
Doménica Herrera Hernández1, Bárbara Abreu2, Tania Siu Xiao3
1Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito 170525, Ecuador.
Medical sciences (Basel, Switzerland)
|November 25, 2024
概括
外科手术期间的β-抑制剂增加了中风风险,但对非心脏手术患者的死亡率没有显著影响. 由于低血压和心的风险增加,仔细选择患者至关重要.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 围绕手术期间使用β-阻断剂对于降低心血管风险是有争议的.
- 对中风,心脏病发作和死亡率等术后结果的影响需要澄清.
研究的目的:
- 系统地审查和元分析外科手术期间β抑制剂的作用.
- 评估对非心脏手术中的死亡率,心肌梗塞 (MI),中风,低血压和心肌梗塞的影响.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 在多个数据库 (PubMed,Cochrane等) 进行了搜索. 对于RCT,队列和病例控制研究 (1999-2024年).
主要成果:
- 包括28项研究,涉及1,342,430名患者.
- 贝塔抑制剂增加了中风风险 (RR 1.42) 和低血压/心.
- 没有与整体死亡率有显著的关联;在高风险小组中可能有好处.
- 在RCT小组中观察到MI的减少.
结论:
- 外科手术期间的β-阻塞剂与中风和不良事件 (低血压,心) 的增加有关.
- 没有对整体死亡率产生重大影响;在特定的高风险患者群体中可能存在益处.
- 精细的患者选择和监测对于在外科手术中安全使用β-阻断剂至关重要.
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