Treating the acute stroke patient as an emergency: current practices and future opportunities.
Treating the acute stroke patient as an emergency: current practices and future opportunities.
复制标题
将急性中风患者视为紧急情况：当前的做法和未来的机会。
DOI：
10.1111/j.1368-5031.2006.00873.x
复制
发表时间：
2006-04
影响因子：
2.6
通讯作者：
Donnan, G
中科院分区：
文献类型：
--
作者：
Davis, S;Lees, K;Donnan, G
随着对缺血性中风和脑出血（ICH）病理生理学演变的理解的进展，急性中风治疗也随之发展。在缺血性中风中，症状出现后 3 小时内溶栓对缺血半暗带进行快速再灌注已被证明是有益的，但目前很少有患者接受治疗，这主要是由于时间窗口短和缺乏中风专业知识。在 ICH 中，最近的一项研究表明，在中风发作 4 小时内使用止血剂可以限制持续出血并改善预后。急性中风治疗的这些进展奠定了“时间就是大脑”这一概念的基础，紧急干预可以限制脑损伤。神经保护治疗可以为更多的中风患者提供接受治疗的前景，可能是在成像之前，甚至是在救护车环境中。事实上，所有中风患者都将受益于在急性中风病房接受多学科护理。
Developments in acute stroke therapy have followed advances in the understanding of the evolving pathophysiology in both ischaemic stroke and intracerebral haemorrhage (ICH). In ischaemic stroke, rapid reperfusion of the ischaemic penumbra with thrombolysis within 3 h of symptom onset is of proven benefit, but few patients currently receive therapy, mainly due to the short-time window and lack of stroke expertise. In ICH, a recent study indicated that a haemostatic agent can limit ongoing bleeding and improve outcomes when administered within 4 h of stroke onset. These advances in acute stroke therapy underlie the concept that ‘time is brain’ and that urgent intervention can limit cerebral damage. Neuroprotective therapy could offer the prospect of a greater proportion of stroke patients receiving treatment, potentially before imaging and even in the ambulance setting. Virtually all stroke patients would benefit from receiving multidisciplinary care in acute stroke units.