直接口服抗凝剂的使用在中风转移为血栓切除术的患者中
Ana Isabel Rodrigues1, Inês V Carvalho2, Carolina Sousa Fernandes2
1Unidade Local de Saúde de Leiria, Leiria, Portugal.
概括
直接口服抗凝剂对接受血栓切除术的缺血性中风患者的结果没有影响. 电脑中风网络的性能和患者的功能状态没有受到先前使用抗凝剂的影响.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 血管医学 血管医学
背景情况:
- 区域远程中风网络有助于在缺血性中风中及时进行血栓切除.
- 直接口服抗凝剂 (DOAC) 对远程中风网络效率和患者结局的影响尚未得到充分证实.
- 了解这些影响对于优化中风治疗途径至关重要.
研究的目的:
- 为了比较在接受DOAC治疗的缺血性中风患者中的时间指标和功能结果,与未接受抗凝药治疗的患者进行比较,这些患者被转移为血栓切除术.
- 为了评估DOACs对再输血率和整体治疗有效性的影响,在一个远程中风网络内.
主要方法:
- 在区域电脑脑中风网络中转移进行血栓切除术的患者的回顾性多中心队列研究 (2016年1月 - 2021年3月).
- 收集的数据包括临床,成像和基于时间的测量.
- 在90天后使用修改的兰金尺度评估功能状态;通过修改的脑梗塞血栓溶解定义的再输血得分为2b-3.
主要成果:
- 在945名血栓切除术患者中,15.98%接受了DOAC.
- 在DOAC和非DOAC组之间没有观察到转移时间 (从初级到三级医院) 或再注血时间 (从三级医院到再注血) 的显著差异.
- 在各组之间,再输血率 (86.64%与83.57%) 和90天的功能结果是相似的.
结论:
- 直接口服抗凝剂的预治疗不会对血栓切除候选人的远程中风网络性能产生负面影响.
- 在接受内血管治疗的缺血性中风患者中,DOAC的使用没有影响再输血率或功能结果.
- 这些发现支持继续将DOAC用户纳入血栓切除术的远程中风途径.
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