血管造影阴性亚脑下流血后的出血模式和临床结果:系统性审查和元分析
Thenul Munasinghe1, Hashni Senanayake2, Samiha Arulshankar1
1School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia.
概括
血管图阴性下大脑下出血 (SAH) 是多种多样的. 出血模式影响并发症和延迟血管病变的检测,指导个性化监测以获得更好的患者结果.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 放射学 放射学是一门学科.
背景情况:
- 血管图阴性脑下下出血 (SAH) 占自发SAH的15%.
- 对血管图谱阴性SAH的监测实践和重复血管成像协议是不一致的.
- 出血模式,临床并发症和延迟检测血管病变之间的关系尚不清楚.
研究的目的:
- 系统地审查和分析患有血管图阴性脑下关节出血的患者的临床结果.
- 调查出血模式与临床并发症之间的关联.
- 根据出血模式评估延迟血管病变检测的产量.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 包括报告血管图阴性SAH临床结果的研究.
- 随机效应一般化线性混合模型用于结果聚合,按出血模式分层 (周周大脑,非周周大脑,扩散,凸度).
主要成果:
- 分析了67项涉及5921名患者的研究数据.
- 在所有模式中,有利的功能结果 (3-6个月) 高 (95-97%).
- 复出率很低 (1-3%). 临床血管 (3-13%) 和急性水头 (7-44%) 根据模式有显著差异.
- 在重复成像 (在中风后≥7天进行) 中发现了82种血管病变,主要是非经脑周周的SAH.
结论:
- 血管造影阴性SAH表现出显著的临床异质性.
- 出血模式与明显的并发症概况和延迟血管病变的不同检测率相关.
- 出血模式可以为个性化监测策略提供信息,但需要前性研究来优化成像间隔.
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