Treatment of massive cerebral infarction.
Treatment of massive cerebral infarction.
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DOI：
10.1007/s11910-005-0040-1
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发表时间：
2005-11-01
影响因子：
5.6
通讯作者：
Mayer, Stephan A
中科院分区：
文献类型：
--
作者：
Palestrant, David;Frontera, Jennifer A;Mayer, Stephan A
中风是美国第三大死亡原因，每3分钟就有一人死于中风。大面积缺血性卒中占缺血性卒中的10%至20%，传统上与高死亡率和发病率相关，需要独特的管理策略。由于对病理生理学的了解增加，管理方面的最新进展可能有助于降低死亡率和改善结局。快速获得再灌注治疗仍然是卒中护理的最关键因素，也是治疗的基石。本文重点介绍了新的治疗方法，包括渗透压治疗、低温治疗、维持正常体温、严格控制血糖、诱导高血压和半颅骨切除术，所有这些都显示出降低死亡率和改善功能结局的希望。这些干预措施已被纳入世界各地的神经重症监护病房。它们很复杂，需要高水平的专业知识，并具有显著的学习曲线。为了使这些新的管理技术是有效的，一个快速的，积极的，细致的，并可能延长医疗管理方法是必要的。为了实现这一目标，越来越需要神经重症监护和中风领域的专家。
Stroke is the third leading cause of death in the United States, with a person dying every 3 minutes of a stroke. Massive ischemic stroke accounts for 10% to 20% of ischemic strokes, has traditionally been associated with a high mortality and morbidity, and requires a unique management strategy. Recent advances in management, fueled by an increased understanding of the pathophysiology, may help decrease mortality and improve outcomes. Rapid access to reperfusion therapies remains the most critical element of stroke care and the cornerstone of therapy. This article focuses on newer therapies, including osmotic therapy, hypothermia, maintained normothermia, strict glycemic control, induced hypertension, and hemicraniectomy, all of which show promise for reducing mortality and improving functional outcome. These interventions have become integrated into neurologic intensive care units around the world. They are complicated, require a high level of expertise, and carry a significant learning curve. In order for these new management techniques to be effective, an expedited, aggressive, meticulous, and potentially prolonged medical management approach is needed. To accomplish this there is a growing need for focused specialists in the areas of neurointensive care and stroke.