非心脏非颅脑手术围手术期脑卒中管理策略

Perioperative stroke management strategies for non‑cardiac non‑neurological surgery

近年来,围手术期脑卒中在我国发病率呈升高趋势,严重影响患者预后,因此备受临床医师尤其是麻醉医师的关注。然而,围手术期脑卒中的识别和诊断较为困难,有效的术前预防是影响患者预后的关键。文章就围手术期脑卒中的定义、病因及危险因素、预防、术中管理、诊断和早期治疗等研究进展进行综述,旨在为麻醉医师全面认识围手术期脑卒中的概念、了解其发生原因、掌握围手术期预防措施和麻醉管理原则,并对术中和术后可疑脑卒中进行初步诊断和治疗提供参考。

In recent years,the incidence of perioperative stroke in China has been increasing,which seriously affects the prognosis among patients.Therefore,it has attracted more and more attention from clinicians,especially anesthesiologists,and effective preoperative prevention is the key to influencing the prognosis of patients.This review summarizes the research advances in its definition,etiology and risk factors,preventive measures,intraoperative management,diagnosis,and early treatment.It aims to provide some references for anesthesiologists to comprehensively understand the concept and etiological factors and grasp the perioperative stroke's perioperative prevention and anesthesia management principles.It also provides a connection for preliminary diagnosis and treatment of suspected stroke during and after an operation.