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急性缺血性脑卒中的管理。

Management of acute ischemic stroke.

机构信息

Servicio de Neurología y Centro de Ictus, Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, España.

Servicio de Neurología y Centro de Ictus, Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, España.

出版信息

Med Clin (Barc). 2023 Dec 7;161(11):485-492. doi: 10.1016/j.medcli.2023.06.022. Epub 2023 Jul 31.

Abstract

Ischemic stroke is a serious neurological condition that requires urgent attention. As a time-dependent disease, acute stroke management must be coordinated and effective to provide the best treatment as early as possible. The treatment of the acute phase of ischemic stroke includes general measures to ensure patient hemodynamic stability, the use of reperfusion therapies (intravenous thrombolytics and mechanical thrombectomy), improving cerebral protection by monitoring the homeostasis of certain variables as blood pressure, glycemia, temperature, or oxygenation, as well as preventing cerebral and systemic complications. Also, it is necessary an early planning of comprehensive rehabilitation. To prevent early recurrences, control of vascular risk factors and antithrombotic treatment is recommended. The management of patients with acute ischemic stroke aims to reverse initial symptoms, to prevent further brain damage, improve functional outcomes and avoid ischemic recurrences.

摘要

缺血性脑卒中是一种严重的神经系统疾病,需要紧急关注。作为一种时间依赖性疾病,急性脑卒中的管理必须协调有效,以便尽早提供最佳治疗。缺血性脑卒中急性期的治疗包括确保患者血流动力学稳定的一般措施,使用再灌注疗法(静脉溶栓和机械取栓),通过监测某些变量(血压、血糖、体温或氧合)的内稳态来改善脑保护,以及预防脑和全身并发症。此外,还需要早期规划全面康复。为了预防早期复发,建议控制血管危险因素和抗血栓治疗。急性缺血性脑卒中患者的管理旨在逆转初始症状,防止进一步的脑损伤,改善功能结局并避免缺血性复发。

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