Widder B
Klinik für Neurologie und Neurologische Rehabilitation, Bezirkskrankenhaus Günzburg.
MMW Fortschr Med. 2001 Mar 15;143(11):28-32.
Up until a few years ago, the acute management of stroke generated a massive sense of nihilism. Since then, things have changed drastically. In the first place, systemic thrombolysis for infarctions in the anterior cerebral circulation is now approved in Germany--although a number of questions still remain unanswered. In the second place, the consequences of a stroke can be effectively mitigated by the rapid application of apparently commonplace "basic measures". These include the maintenance of a "high/normal" blood pressure, control of respiratory function with aspiration prophylaxis, securement of normal glycemia, optimization of cardiac output and microcirculation, lowering of elevated temperatures, and relief of increased intracerebral pressure, if necessary via a craniotomy. As required by the stroke unit concept--which is now widely established--rapid referral of the patient, and interdisciplinary management by an experienced team is of decisive importance for the prognosis.
直到几年前，中风的急性治疗还引发了一种强烈的虚无主义情绪。从那时起，情况发生了巨大变化。首先，德国现已批准对大脑前循环梗死进行全身溶栓治疗——尽管仍有一些问题未得到解答。其次，通过迅速应用看似平常的“基本措施”，中风的后果可以得到有效缓解。这些措施包括维持“高/正常”血压、通过预防误吸控制呼吸功能、确保血糖正常、优化心输出量和微循环、降低体温升高以及必要时通过开颅手术缓解颅内压升高。按照现已广泛确立的中风单元概念的要求，患者的快速转诊以及由经验丰富的团队进行跨学科管理对预后至关重要。
