在急性缺血性中风中进行血栓切除术后的最佳静脉血压控制:系统性审查和元分析
Baikuntha Panigrahi1, Rohit Bhatia1, Partha Haldar2
1Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Annals of Indian Academy of Neurology
|May 7, 2025
概括
建议在内血管血栓切除术后进行常规的缩血压控制. 密集的血压管理在随机对照试验中显示出较差的功能结果,尽管有矛盾的观察数据.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 干预性放射学 干预性放射学
背景情况:
- 在内静脉血栓切除术 (EVT) 后的最佳静脉血压 (SBP) 控制仍未确定.
- 这项研究比较了密集 (<140 mmHg) 与常规 (<180 mmHg) SBP控制在EVT后24小时内.
研究的目的:
- 评估SBP密集控制对EVT后功能结果的影响.
- 主要终点:功能独立 (90天后修改的兰金尺度得分为0-2).
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 包括随机对照试验 (RCT) 和观察性研究至2024年3月.
- 排除了没有初级结果数据,病例系列和报告的研究.
主要成果:
- 对5个RCT (n=5152) 的分析有利于传统的SBP控制 (RR 0.81;P < 0.0001).
- 死亡率和症状性内出血率在各组之间相似.
- 观察性研究表明,在密集控制下,结果更好 (RR 1.28;P < 0.00001).
结论:
- 主要RCT分析表明,密集的SBP控制与较差的功能结果有关.
- 死亡率或症状性内出血没有显著差异.
- 根据1级RCT证据,建议采用传统的治疗方法.
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