儿童脑血管损伤:一个前性的多中心ATOMAC+研究
Ruth A Lewit1, Todd A Nickoles, Regan Williams
1From the Le Bonheur Children's Hospital, Division of Pediatric Surgery (R.A.L., R.W., S.G., J.W.E.); Division of Pediatric Surgery, Department of Surgery (R.A.L., R.W., S.G., J.W.E.), College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Phoenix Children's Hospital (T.A.N., D.M.N., R.L.S.); University of Arizona College of Medicine-Phoenix (D.M.N.), Phoenix, Arizona; Children's Health, Dallas, Texas (M.R.); Division of Pediatric Surgery (M.R.), University of Texas Southwestern Medical Center; Oklahoma Children's Hospital (J.J.J.), OU Health; Department of Surgery (J.J.J.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; Dell Children's Medical Center of Central Texas (J.A.N., K.A.L.), Austin, Texas; Dell Medical School (J.A.N., K.A.L.), University of Texas at Austin; Arkansas Children's Hospital (R.T.M.); Department of Surgery (R.T.M.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Department of Surgery (R.T.M.), College of Medicine, University of Arizona, Phoenix, Arizona.
在儿童中,体脑血管损伤 (BCVI) 查发现1%的发病率,具有显著的中风风险. 治疗应用不一致,甚至在诊断后也发生了中风.
科学领域:
- 儿童创伤外科手术
- 血管外科 血管外科
- 紧急医疗 紧急医疗
背景情况:
- 儿童中脑血管损伤 (BCVI) 的发生程度尚不清楚.
- 目前对儿科BCVI的查率很低 (16.5%).
- 需要一个标准化查指南对儿科BCVI检测和结果的影响.
研究的目的:
- 评价孟菲斯标准的有效性,用于查儿科突击创伤患者的BCVI.
- 为了确定儿童中BCVI的发病率和结果.
- 评估儿童BCVI患者治疗的应用和中风的发生情况.
主要方法:
- 对头部,脸部或部受伤的儿童 (15岁以下) 的前性,多机构的观察性研究.
- 使用孟菲斯标准进行查;对阳性查建议使用CT血管图.
- 以创伤负担为指导的治疗,随着7-10天的随访成像.
主要成果:
- 包括2,285名患者;520人 (23%) 符合孟菲斯标准,222人 (42.5%) 接受成像.
- 在25名患者中发现了30个BCVI (1.05%的发病率).
- 六名患有BCVI的儿童 (24%) 遭受了中风,无论治疗状态如何.
结论:
- 儿科BCVI的发病率为1%,并带有相当大的中风风险.
- 孟菲斯标准显示BCVI检测的灵敏度为88%.
- 不一致的治疗应用和诊断后的中风突出了需要改进的管理协议.


