在非全胸切除术和全胸切除术期间的中风衰弱与进入心脏门手术的心脏门手术
Ahmad S Abdelrazek1, Kevin L Greason1, Alex Lee2
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
JTCVS open
|March 10, 2025
概括
与全胸切除术相比,使用部分胸腔切除术的心脏门手术增加了中风风险,尽管大多数中风是轻微的. 胸切除术没有显示增加中风风险. 总体而言,中风风险仍然很低.
科学领域:
- 心血管外科心血管外科
- 神经外科 神经外科
- 临床结果研究研究
背景情况:
- 之前的研究表明,在心脏门手术中,非全胸切除术的中风风险更高.
- 这些中风的临床影响和严重程度仍未得到充分研究.
研究的目的:
- 确定心脏门手术后手术后中风的发生率和临床意义.
- 为了比较全胸切除术,部分胸切除术和胸腔切除术的方法之间的中风风险.
主要方法:
- 对12406名接受心脏门手术的患者进行分析 (1997年1月至2021年3月).
- 接入方法包括完全的中间骨切除 (88%),部分骨切除 (1.8%) 和胸腔切除 (11%).
- 在出院时使用修改的兰金尺度 (mRS) 评估中风;多变量逻辑回归分析了中风风险.
主要成果:
- 卒中发生率为1.0% (全胸切除),2.7% (部分胸切除) 和1.2% (胸切除) (P=.044).
- 部分胸腔切除显著增加了中风风险,而不是全胸腔切除 (OR 3.73,P=.010).
- 胸切除术没有显示中风风险显著增加,而不是全胸切除术 (OR 1.34). 大多数中风都是轻微的 (mRS ≤2,62%). 与中风相关的死亡率很低 (1.3%).
结论:
- 与全胸切除相比,部分胸切除与中风风险增加有关.
- 在心脏门手术中进行胸腔切除术的机会与中风风险增加无关.
- 整体中风风险很低,大多数中风导致轻度残疾.
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