小儿卒中的治疗方法与进展
Therapeutic approaches and advances in pediatric stroke.
作者信息
Kirton Adam, deVeber Gabrielle
机构信息
Children's Stroke Program, Department of Pediatrics, Division of Neurology, Faculty of Medicine, University of Toronto, Hospital for Sick Children, M5G 1X8 Toronto, ON, Canada.
出版信息
NeuroRx. 2006 Apr;3(2):133-42. doi: 10.1016/j.nurx.2006.01.003.
Evidence-based therapeutic interventions for pediatric ischemic cerebrovascular disease are beginning to emerge. The primary therapeutic target is usually the pathological prothrombotic disturbance that underlies the majority of pediatric stroke. A battle between anticoagulation and anti-platelet therapies continues to provide controversy and is the inspiration for upcoming randomized trials. Supportive care and neuroprotective strategies are an important consideration in children with stroke. Attempts to determine the safety of acute thrombolytic interventions are also underway. Finally, unique medical and surgical treatments for specific diseases leading to stroke in children continue to evolve. After briefly summarizing the epidemiology, pathophysiology, diagnosis, and outcomes of ischemic strokes in children, treatment approaches and alternatives will be reviewed in detail with emphasis placed on current areas of controversy and future directions for clinical research.
针对小儿缺血性脑血管疾病的循证治疗干预措施正开始出现。主要治疗靶点通常是大多数小儿卒中所基于的病理性促血栓形成紊乱。抗凝治疗与抗血小板治疗之间的争论仍在继续，这也是即将开展的随机试验的灵感来源。支持性治疗和神经保护策略是卒中患儿的重要考量因素。确定急性溶栓干预安全性的尝试也在进行中。最后，针对导致小儿卒中的特定疾病的独特医学和外科治疗方法也在不断发展。在简要总结小儿缺血性卒中的流行病学、病理生理学、诊断和预后之后，将详细回顾治疗方法及替代方案，重点关注当前存在争议的领域以及临床研究的未来方向。
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