Department of Neurology, Mayo Clinic Florida, Jacksonville, Florida 32224, USA.
Semin Neurol. 2010 Nov;30(5):461-8. doi: 10.1055/s-0030-1268859. Epub 2011 Jan 4.
The initial management of a patient with suspected stroke necessitates a rapid and focused evaluation. Establishing the time of symptom onset, performing a focused neurologic examination, and interpreting ancillary tests facilitates delivery of acute stroke therapies to eligible patients. This review emphasizes the fundamentals of urgent stroke evaluation and evidence-based acute ischemic stroke therapies. Results from randomized clinical trials of intravenous thrombolysis, glucose management, and blood pressure management in acute ischemic stroke patients will be highlighted. External ultrasound as an adjunct to intravenous thrombolysis and treatment of those patients that wake up with stroke symptoms will also be discussed.
疑似中风患者的初始管理需要快速而集中的评估。确定症状发作时间、进行重点神经检查以及解读辅助检查有助于为符合条件的患者提供急性中风治疗。本篇综述强调了紧急中风评估和基于证据的急性缺血性中风治疗的基础。将重点介绍急性缺血性中风患者静脉溶栓、血糖管理和血压管理的随机临床试验结果。还将讨论将外部超声作为静脉溶栓辅助手段以及治疗那些中风症状发作后醒来的患者。
