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对于远距离/中等血管阻塞的内血管血栓切除术中全身对非全身麻醉:系统性审查和元分析

Luiz Guilherme Silva Almeida¹, Ocílio Ribeiro Gonçalves², Mariana Lee Han³

¹Department of Medicine, Catholic University of Brasília, QS 07 Lote 01 Bloco L, Taguatinga Sul/DF, 71966-700, Brasília, Brazil. lguilherme1109@gmail.com.

Clinical neuroradiology

|November 25, 2025

概括

总麻醉 (GA) 增加90天的死亡率内血管血栓切除术 (EVT) 对于远端和中等血管封闭 (DMVOs). 虽然再输和功能结果相似,但GA可能会增加症状性内出血 (sICH) 的风险.

科学领域:

神经学神经学
干预心脏病学干预心脏病学
麻醉学麻醉学

背景情况:

内血管血栓切除术 (EVT) 越来越多地用于远端和中等血管封闭 (DMVO).
麻醉的选择,全身麻醉 (GA) 与非全身麻醉 (非GA),可能会影响EVT程序的临床结果.
评估麻醉类型的影响对于优化DMVO治疗中的患者护理至关重要.

研究的目的:

为了比较全身麻醉 (GA) 和非GA之间的临床结果,在DMVOs接受EVT的患者中.
评估麻醉类型对成功再输血,90天死亡率,功能结果和症状内出血 (sICH) 的影响.

主要方法:

在PubMed,Embase,Cochrane图书馆和科学网上进行了系统的文献搜索.
五项涉及1643名患者的研究被纳入了元分析.
主要结局包括再输血,90天死亡率,优异的功能结局 (修改的兰金尺度0-1) 和sICH. 使用随机效应模型计算了风险比率 (RR) 和95%置信区间 (CI).

主要成果:

在GA和非GA组之间没有观察到成功的再输液或优秀的功能结果 (mRS 0-1在90天) 的显著差异.
通用麻醉与90天死亡率显著增加有关 (RR 1.55;95% CI 1.23-1.96).
虽然初步分析没有显示sICH的显著差异,但一个留出一个分析表明GA的潜在风险增加 (RR 3.88;95% CI 1.79-8.41).

结论:

全身麻醉与DMVOs在EVT中的90天死亡率增加有关.
麻醉类型没有显著影响再输血率或功能恢复.
随着GA的症状性内出血的潜在风险增加,需要在前性研究中进一步调查以指导麻醉策略.

关键词:

有意识的镇静剂.远端血管闭塞的情况血管内血栓切除术是指血管内血栓切除术.整体麻醉是一种全身麻醉.中等血管的闭塞.

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