大脑静脉血栓形成的结果需要机械通风
Jayantee Kalita1, Prakash C Pandey1, Nagendra B Gutti1
1Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India.
Journal of clinical medicine
|May 14, 2025
概括
18.4%的脑静脉血栓 (CVT) 患者需要机械呼吸 (MV),导致27.8%的死亡率. 然而,90.7%的幸存者在三个月内取得了良好的功能结果.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 血管医学 血管医学
背景情况:
- 需要机械通风 (MV) 的脑静脉血栓 (CVT) 患者可能面临严重的血栓形成状态和更糟糕的结果.
- 关于需要MV的CVT患者的特定特征和结果的研究有限.
研究的目的:
- 为了比较需要MV和不需要MV的CVT患者之间的临床风险因素,放射学发现和结果.
- 确定与CVT患者的死亡率和不良功能结果相关的因素.
主要方法:
- 一系列连续的CVT患者被分析为临床细节,前血栓状况和神经成像发现 (MRI/MRV).
- 患者被送入ICU,并根据格拉斯哥昏迷量表 (GCS) 评分和动脉血液气体分析进行直管.
- 治疗涉及肝素,然后是口服抗凝药;记录了住院死亡和3个月功能结果 (修改的兰金表).
主要成果:
- 在98名CVT患者中,45.9%需要ICU护理,18.4% (18名患者) 需要MV,平均为6.5天.
- MV患者的疾病持续时间更短,GCS得分更低,C蛋白缺乏率更高.
- 死亡率在MV组为27.8%,而非MVICU组为14.8%,非MV非ICU组为5.7%. MV与死亡 (AHR 0.40) 和3个月的不良结果 (AHR 0.45) 相关.
结论:
- 大约18.4%的CVT患者需要机械呼吸,死亡风险为27.8%.
- 尽管死亡率很高,但绝大多数 (90.7%) 在MV治疗中生存的CVT患者在三个月内获得了良好的功能结果.
- 在CVT患者中,机械通风与死亡率增加和功能表现不佳有关,这凸显了密集管理策略的必要性.
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