Suppr超能文献

[急性血管内卒中治疗的围介入期管理]

[Periinterventional management of acute endovascular stroke treatment].

作者信息

Schönenberger S, Bösel J

机构信息

Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

Neurologische Klinik, Klinikum Kassel, Kassel, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2019 Oct;114(7):604-612. doi: 10.1007/s00063-019-00612-y. Epub 2019 Aug 28.

Abstract

Mechanical thrombectomy (MT) is more effective than standard medical treatment with or without intravenous thrombolysis alone for treating acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) in the anterior circulation. MT is therefore recommended in current international guidelines, and many acute-care hospitals and stroke centers will have to prepare for providing this treatment in an optimal way. Beside successful recanalization, management before, during, and after the intervention represents significant challenges. One unresolved matter is whether the choice of anesthetic strategy, including airway management, affects functional outcome. Based on current data, treatment under general anesthesia (GA)-respecting predefined safety criteria and contraindications-seem seems to be equivalent to treating the patient in conscious sedation (CS) and not necessarily disadvantageous. Aspects of periinterventional management of MT, including pragmatic recommendations concerning logistics, monitoring, postprocedural steps, and follow-up imaging, will be summarized in this overview.

摘要

对于治疗由前循环大血管闭塞(LVO)引起的急性缺血性卒中(AIS),机械取栓术(MT)比单独采用标准药物治疗(无论是否联合静脉溶栓)更有效。因此,MT在当前国际指南中得到推荐,许多急症医院和卒中中心将不得不做好以最佳方式提供这种治疗的准备。除了成功再通之外,干预前、干预期间和干预后的管理也面临重大挑战。一个尚未解决的问题是麻醉策略的选择(包括气道管理)是否会影响功能结局。根据目前的数据,在遵循预定义的安全标准和禁忌症的情况下,全身麻醉(GA)下的治疗似乎与清醒镇静(CS)下治疗患者相当,且不一定有劣势。本综述将总结MT介入治疗管理的各个方面,包括有关后勤、监测、术后步骤以及随访成像的实用建议。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验