由于创伤性脊椎动脉损伤后的神经外科干预,抗血栓治疗延迟增加了中风风险
Zixin Yi1, Jessica Vankawala1, Manisha Koneru1,2
1Cooper Medical School of Rowan University, Camden, NJ, USA.
Neurosurgical review
|August 19, 2025
概括
在接受神经外科手术的创伤性脊椎动脉损伤 (TVAI) 患者中,延迟抗血栓治疗显著增加了中风风险. 在这个高风险群体中,早期的抗血栓启动对于预防缺血事件至关重要.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
背景情况:
- 创伤性脊椎动脉损伤 (TVAI) 是已知的缺血性中风风险因素.
- 及时的抗血栓治疗是TVAI中风预防的标准.
- 在TVAI患者的神经外科干预通常需要延迟抗血栓剂,因为出血问题.
研究的目的:
- 评估推迟抗血栓治疗对需要神经外科干预的TVAI患者中风风险的影响.
主要方法:
- 一个1级创伤中心的7年TVAI注册 (2016-2023) 的回顾性审查.
- 将接受神经外科手术的患者与没有接受神经外科手术的患者之间的结果进行比较.
- 统计分析包括相对风险 (RR) 和可归因风险 (AR).
主要成果:
- 在121名TVAI患者中,有44人接受了神经外科手术,抗血栓开始平均延迟2天 (p < 0.001).
- 脑卒中发生率在神经外科组 (20.5%) 与对照组 (5.19%) 相比显著更高 (p = 0.016).
- 这种延迟与中风风险 (RR) 增加了3.94倍,可归因风险 (AR) 增加了15.3%.
结论:
- 在接受神经外科手术的TVAI患者中,延迟抗血栓启动与大大增加中风风险有关.
- 需要进一步的多中心研究来开发神经外科技术,以便更早,更安全地使用抗血栓剂.
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