脑静脉和鼻血栓的压缩手术后开始抗凝治疗的时间:一项观察性研究
Mariana Costa Taveira1,2, Sanjith Aaron3, Jorge M Ferreira4
1Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Portugal.
概括
在脑静脉血栓瘤 (CVT) 解压手术后24小时内开始或恢复抗凝药,在出血或血栓事件中没有显著差异. 这种时间不会影响患者的结果或残疾.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 血管医学 血管医学
背景情况:
- 抗凝药是脑静脉血栓症 (CVT) 的首要治疗方法.
- 减压手术是严重的CVT病例的关键干预措施,具有大型病变和即将发生的,需要暂时停止抗凝血治疗.
- 确定在手术后重新启动抗凝剂的最佳时间对于患者管理至关重要.
研究的目的:
- 确定在患有严重脑静脉血栓症 (CVT) 的患者进行解压性手术后启动或恢复抗凝治疗的最佳时间.
主要方法:
- 一项前性的跨国队列观察研究 (DECOMPRESS2) 涉及118名患有严重CVT的患者,他们接受了减压手术.
- 患者被分为手术后早期 (<24小时) 和晚期 (<24小时) 抗凝血剂组.
- 倾向性得分匹配和后勤回归被用来分析新的出血和静脉血栓事件,死亡和残疾 (修改的兰金级) 的频率.
主要成果:
- 在分析的90名患者中,39%接受了早期抗凝剂 (<24小时),61%接受了晚期抗凝剂 (24小时).
- 在早期和晚期抗凝剂组之间,在新出血或静脉血栓事件的总体频率上没有观察到统计学上显著的差异 (31%对24%).
- 抗凝药时间与出院时或1年随访时的死亡或残疾没有显著的相关性.
结论:
- 在CVT解压手术后,开始或恢复抗凝血的时间似乎不会显著影响新的出血或血栓事件的风险.
- 关于死亡和残疾的患者结局不受抗凝血药物治疗时间和CVT压缩后手术时间的影响.
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