摘要
重症/大面积脑梗死治疗难、预后差,定义不统一且针对性研究相对滞后。该草案推荐了相关定义标准和诊断流程,特别强调对重症/大面积脑梗死需重点关注恶性脑水肿预防和早期预测;加强监测意识和生命体征,及预防管理肺部感染等并发症;提出了在重症患者中使用脑梗死特异性疗法(如静脉溶栓、血管内介入、抗血小板和抗凝治疗)的特殊建议;指出脑水肿和颅高压内外科治疗和早期康复在重症/大面积脑梗死患者的个体化应用需要更多研究。
Severe/massive ischaemic stroke is difficult to treat and has poor prognosis.There are limited studies for specific treatment of these conditions and no consensus on their definitions.This proposal suggests definitions and a flowchart for the diagnosis and treatment of these conditions.We focus on predicting and preventing malignant oedema at an early stage,monitoring the level of consciousness and vital signs,and the prevention and management of complications(eg.pulmonary infections).We particularly provide suggestions for the treatment with intravenous thrombolysis,endovascular treatment,antiplatelet and anticoagulation.More studies are warranted to support individualised management of infarct swelling,intracranial hypertension and early rehabilitation for severe/massive ischaemic stroke.
作者
吴思缈
吴波
郭富强
张世洪
郝子龙
杨东东
李小刚
吴碧华
王淳
段劲峰
凌天金
张浩
刘鸣
无
WU Simiao;WU Bo;GUO Fuqiang;ZHANG Shihong;HAO Zilong;YANG Dongdong;LI Xiaogang;WU Bihua;WANG Chun;DUAN Jingfeng;LING Tianjin;ZHANG Hao;LIU Ming;on behalf of Severe Ischaemic Stroke Collaboration(Department of Neurology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Neurology,Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital,Chengdu,Sichuan 610072,P.R.China;Department of Neurology,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610075,P.R.China;Department of Neurology,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,P.R.China;Department of Neurology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 634700,P.R.China;Department of Neurology,People’s Hospital of Deyang City,Deyang,Sichuan 618000,P.R.China;Department of Neurology,Mianyang Central Hospital,Mianyang,Sichuan 621000,P.R.China;Department of Neurology,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China;Department of Neurology,Jiangyou People’s Hospital,Jiangyou,Sichuan 621000,P.R.China)
出处
《华西医学》
CAS
2019年第10期1096-1108,共13页
West China Medical Journal
基金
四川省科学技术厅重点研发项目（2017SZ0007）
四川省应用基础研究（2018JY0101）
关键词
脑梗死
重症
大面积
诊治
流程
Ischaemic stroke
Severe
Massive
Diagnosis and treatment
Flowchart
