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治疗性低温与缺血性中风:文献综述

Therapeutic hypothermia and ischemic stroke: A literature review.

作者信息

Tahir Rizwan A, Pabaney Aqueel H

机构信息

Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.

出版信息

Surg Neurol Int. 2016 Jun 3;7(Suppl 14):S381-6. doi: 10.4103/2152-7806.183492. eCollection 2016.

Abstract

BACKGROUND

Ischemic stroke is the fifth leading cause of death in the US. Clinical techniques aimed at helping to reduce the morbidity associated with stroke have been studied extensively, including therapeutic hypothermia. In this study, the authors review the literature regarding the role of therapeutic hypothermia in ischemic stroke to appreciate the evolution of hypothermia technology over several decades and to critically analyze several early clinical studies to validate its use in ischemic stroke.

METHODS

A comprehensive literature search was performed using PubMed and Google Scholar databases. Search terms included "hypothermia and ischemic stroke" and "therapeutic hypothermia." A comprehensive search of the current clinical trials using clinicaltrials.gov was conducted using the keywords "stroke and hypothermia" to evaluate early and ongoing clinical trials utilizing hypothermia in ischemic stroke.

RESULTS

A comprehensive review of the evolution of hypothermia in stroke and the current status of this treatment was performed. Clinical studies were critically analyzed to appreciate their strengths and pitfalls. Ongoing and future registered clinical studies were highlighted and analyzed compared to the reported results of previous trials.

CONCLUSION

Although hypothermia has been used for various purposes over several decades, its efficacy in the treatment of ischemic stroke is debatable. Several trials have proven its safety and feasibility; however, more robust, randomized clinical trials with large volumes of patients are needed to fully establish its utility in the clinical setting.

摘要

背景

缺血性中风是美国第五大死因。旨在帮助降低中风相关发病率的临床技术已得到广泛研究,包括治疗性低温。在本研究中,作者回顾了关于治疗性低温在缺血性中风中作用的文献,以了解低温技术在几十年间的发展,并批判性地分析了几项早期临床研究,以验证其在缺血性中风中的应用。

方法

使用PubMed和谷歌学术数据库进行了全面的文献检索。检索词包括“低温与缺血性中风”和“治疗性低温”。使用关键词“中风与低温”对clinicaltrials.gov上当前的临床试验进行了全面搜索,以评估在缺血性中风中使用低温的早期和正在进行的临床试验。

结果

对中风中低温的发展演变及该治疗方法的现状进行了全面综述。对临床研究进行了批判性分析,以了解其优点和缺陷。突出显示并分析了正在进行和未来注册的临床研究,并与先前试验报告的结果进行了比较。

结论

尽管几十年来低温已被用于各种目的,但其在治疗缺血性中风方面的疗效仍存在争议。几项试验已证明其安全性和可行性;然而,需要进行更有力、纳入大量患者的随机临床试验,以充分确定其在临床环境中的效用。

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