Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
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DOI：
10.1161/str.0b013e3182587839
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发表时间：
2012-06-01
期刊：
影响因子：
8.3
通讯作者：
Vespa, Paul
中科院分区：
文献类型：
--
作者：
Connolly, E. Sander, Jr.;Rabinstein, Alejandro A.;Vespa, Paul
目的-本指南的目的是提出目前和全面的建议，诊断和治疗蛛网膜下腔出血（aSAH.Methods-A）的正式文献检索MEDLINE（2006年11月1日至2010年5月1日）进行。使用证据表合成数据。写作小组成员通过电话会议讨论数据得出的建议。美国心脏协会中风理事会的证据等级分级算法被用于对每个建议进行分级。该指南草案由7名专家同行评审员以及卒中理事会领导和卒中监督委员会的成员进行了审查。本指南每3年更新一次，旨在为aSAH患者的护理提供基于结果证据的指南。该指南的重点细分为发生率、风险因素、预防、自然史和结局、诊断、再出血预防、破裂动脉瘤的手术和腔内修复、护理系统、修复期间的麻醉管理、血管痉挛和迟发性脑缺血的管理、脑积水的管理、癫痫发作的管理，结论-aSAH是一种严重的医疗状况，其结果可能会受到早期，积极，专家护理的显著影响。该指南为aSAH患者的目标导向治疗提供了一个框架。（中风。2012; 43：1711-1737）。
Purpose-The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH).Methods-A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. The guideline draft was reviewed by 7 expert peer reviewers and by the members of the Stroke Council Leadership and Manuscript Oversight Committees. It is intended that this guideline be fully updated every 3 years.Results-Evidence-based guidelines are presented for the care of patients presenting with aSAH. The focus of the guideline was subdivided into incidence, risk factors, prevention, natural history and outcome, diagnosis, prevention of rebleeding, surgical and endovascular repair of ruptured aneurysms, systems of care, anesthetic management during repair, management of vasospasm and delayed cerebral ischemia, management of hydrocephalus, management of seizures, and management of medical complications.Conclusions-aSAH is a serious medical condition in which outcome can be dramatically impacted by early, aggressive, expert care. The guidelines offer a framework for goal-directed treatment of the patient with aSAH. (Stroke. 2012; 43: 1711-1737.)