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大型头手术后心肌损伤

Phillip Staibano^1,2, Amit X Garg^3,4,5, Matthew T V Chan⁶

¹Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

JAMA otolaryngology-- head & neck surgery

|April 24, 2025

概括

在非心脏手术 (MINS) 后的心肌损伤在头部和部手术中很常见,特别是在老年患者中. 通过托罗邦素T监测进行早期检测至关重要,因为它会显著影响30天死亡率和住院时间.

科学领域:

心脏病学心脏病学
在瘤学瘤学.
外科手术医疗外科手术

背景情况:

非心脏手术 (MINS) 后的心肌损伤是已知的死亡率预测因素.
大型头手术后MINS的发生率和影响尚未得到充分证实.

研究的目的:

为了确定在接受重大头手术的患者中MINS的发病率.
评估MINS在这个患者群体中的临床影响和预后影响.

主要方法:

一项使用VISION研究数据的队列研究 (N>15,000名非心脏手术患者).
包括648名接受头部和部重大手术的患者,在术后1-3天使用托罗邦素T (TnT) 对MINS进行查.
通过特定的hsTnT水平或心脏缺血症定义的MINS.

主要成果:

总体而言,MINS发生率为11.9%,在75岁以上的患者中增加到23.8%.
在没有TnT监测的情况下,近70%的MINS病例未被检测到.
在患有缺血病特征的患者中,MINS与30天死亡率 (HR 5.51) 和长时间住院时间的增加有关.

结论:

非心脏手术后的心肌损伤在头癌患者中很常见,特别是老年人和患有并发症的人.
热素T监测对于检测MINS至关重要,这与不良结果有关.
需要进一步的研究来验证MINS查协议,以改善患者的治疗结果.

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