Kutlubaev M A, Nikolaeva I E, Oleinik B A, Kutlubaeva R F
Bashkir State Medical University, Ufa, Russia.
Republican Cardiological Center, Ufa, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(3. Vyp. 2):10-15. doi: 10.17116/jnevro202112103210.
The frequency of perioperative stroke in cardiosurgical practice may reach up to 10%. The risk of stroke is especially high after coronary artery bypass surgery and valve replacement. Perioperative stroke is related to embolism with the fragments of atherosclerotic plaque, arterial hypotension, cardiac arrhythmias, hypercoagulation, etc. The likelihood of stroke can be reduced by preoperative assessment of the patient. It is important to control blood pressure and saturation during the surgery. The manipulation on aorta should be minimized in order to reduce the risk of perioperative stroke. Important role belongs to timely identification of those who developed stroke after surgery. The only possible method of reperfusion therapy in perioperative stroke is mechanical thrombectomy.
心脏外科手术中围手术期卒中的发生率可能高达10%。冠状动脉搭桥手术和瓣膜置换术后卒中风险尤其高。围手术期卒中与动脉粥样硬化斑块碎片栓塞、动脉低血压、心律失常、高凝状态等有关。术前对患者进行评估可降低卒中的可能性。手术期间控制血压和血氧饱和度很重要。应尽量减少对主动脉的操作，以降低围手术期卒中风险。及时识别术后发生卒中的患者至关重要。围手术期卒中唯一可能的再灌注治疗方法是机械取栓术。
