急性腦卒中救治規(guī)范與流程英文

Title:ActStrokeTherapy:ProtocolandProcedures匯報(bào)人：文小庫(kù)2024-01-11CONTENTSIntroductionPathophysiologyofStrokeStrokeTherapeuticsprotocolsStrokeProceduresPostStrokeCareandRehabilitationIntroduction01ActStrokereferstotherapidonsetoffocalneurologicaldeficit(s)causedbyfocalcerebralischemiaorintracerebralhemorrhage.Itisamedicalemergencythatrequiresimmediatetreatmenttominimizelong-termdisabilityandpreventdeath.DefinitionofActStrokeStandardizedprotocolforstroketreatmentensuresthatpatientsreceivepromptandeffectivecare,minimizingtheimpactofthestrokeontheirqualityoflife.Protocolshelptoensurethatallhealthcareprovidersinvolvedinstrokecarearefollowingbestpracticesandguidelines,leadingtoconsistentandhigh-qualitycare.ImportanceofStrokeTherapeuticsProtocolStrokeisaleadingcauseofdeathanddisabilityworldwide,affectingmillionsofpeopleeachyear.Theglobalburdenofstrokeisincreasing,duetopopulationaging,unhealthylifestyles,andtheriseinriskfactorssuchashypertension,diabetes,andobesity.GlobalBurdenofStrokePathophysiologyofStroke02由于動(dòng)脈粥樣硬化、血栓等原因?qū)е履X血管阻塞，引起腦組織缺血、缺氧性壞死。突然出現(xiàn)的偏癱、失語(yǔ)、感覺障礙等局灶性神經(jīng)功能缺損癥狀。盡早恢復(fù)缺血區(qū)腦組織的血液供應(yīng)，防止腦水腫、顱內(nèi)壓升高和繼發(fā)性血栓形成。定義癥狀治療原則IschemicStroke由于高血壓、動(dòng)脈瘤等原因?qū)е履X血管破裂出血，引起腦實(shí)質(zhì)內(nèi)或腦室內(nèi)出血。突然出現(xiàn)的頭痛、嘔吐、意識(shí)障礙、偏癱等局灶性或全腦性癥狀。控制出血、降低顱內(nèi)壓、防止腦疝形成，同時(shí)積極處理原發(fā)病。定義癥狀治療原則HemorhagicStroke由于動(dòng)脈瘤、先天性腦血管畸形等原因?qū)е履X實(shí)質(zhì)內(nèi)血管破裂出血，血液流入蛛網(wǎng)膜下腔。定義癥狀治療原則突然出現(xiàn)的頭痛、嘔吐、意識(shí)障礙等全腦癥狀，常伴有頸項(xiàng)強(qiáng)直等腦膜刺激征。降低顱內(nèi)壓、緩解疼痛、防止繼發(fā)性腦血管痙攣，同時(shí)積極處理原發(fā)病。030201SubarachnoidHemorrhageStrokeTherapeuticsprotocols03ThrombolysisThrombolysisisatreatmentthatusesdrugstobreakupbloodclotsinthebrain,restoringbloodflowtotheaffectedarea.Itisatime-dependenttreatment,andearlyadministrationcansignificantlyimproveoutcomes.EndoscopicThrombectomyEndoscopicthrombectomyisasurgicalprocedurethatusesanendoscopetoremovebloodclotsfromthebrain.Itistypicallyusedwhenthrombolysisisnotanoptionduetothelocationorsizeoftheclot.ThrombolysisandEndoscopicThrombologyVSAnticoagulantsaredrugsthatpreventbloodclotsfromformingbyinhibitingtheactivityofclottingfactors.Theyarecommonlyusedtotreatatrialfibrillationandotherconditionsthatincreasetheriskofstroke.AntiplateletAgentsAntiplateletagentsaredrugsthatpreventplateletsfromaggregating,therebyreducingtheriskofbloodclots.Commonlyusedantiplateletagentsincludeaspirinandclopidogrel.AnticoagulantsAnticoaguationTherapyAbciximabisamonoclonalantibodythatblockstheplateletglycoproteinIIb/IIIareceptor,preventingplateletaggregation.Itisusedinthetreatmentofacutecoronarysyndromesandstentthrombosis.EptifibatideisacyclicpeptidethatbindstotheplateletglycoproteinIIb/IIIareceptor,blockingplateletaggregation.Itisusedinthetreatmentofacutecoronarysyndromesandstentthrombosis.AbciximabEptifibatideAntilateletAgentsControllingbloodpressureisessentialinreducingtheriskofstroke.Medicationssuchasangiotensin-convertingenzymeinhibitors,angiotensinIIreceptorblockers,anddiureticscanhelplowerbloodpressure.ControlledBloodPressureVasculardenervationisasurgicalprocedurethatinvolvesremovingthenervesthatcontrolbloodvesselcontraction,allowingformoreprecisecontrolofbloodpressure.Itistypicallyusedinpatientswhocannotcontroltheirbloodpressurewithmedication.VascularDenervationHypertensionManagementInsulinTherapyInsulintherapyisusedtolowerbloodglucoselevelsinpatientswithhyperglycemia.Itcanbeadministeredintravenouslyorsubcutaneouslydependingontheseverityofthecondition.OralAntidiabeticAgentsOralantidiabeticagentsaredrugsthathelpcontrolbloodglucoselevelsbystimulatinginsulinproductionorinhibitingglucoseproductionintheliver.Commonlyusedoralantidiabeticagentsincludemetforminandsulfonylureas."HyperglycemiaControlStrokeProcedures04確保患者被快速識(shí)別為疑似卒中，并立即送往醫(yī)療機(jī)構(gòu)。確?；颊吆粑罆惩ǎ匾獣r(shí)進(jìn)行插管或使用呼吸機(jī)。在轉(zhuǎn)運(yùn)過(guò)程中監(jiān)測(cè)并控制患者的血壓和血糖水平。根據(jù)患者情況給予抗血小板或抗凝藥物治療。快速識(shí)別保持呼吸道通暢控制血壓和血糖抗血小板和抗凝治療PrehospitalManagement到達(dá)急診室后，對(duì)患者進(jìn)行初步評(píng)估，確定卒中類型和嚴(yán)重程度。詳細(xì)了解患者病史，包括既往卒中史、高血壓、糖尿病等。進(jìn)行詳細(xì)的神經(jīng)系統(tǒng)檢查，評(píng)估患者神經(jīng)功能狀況。進(jìn)行必要的實(shí)驗(yàn)室檢查，如血常規(guī)、凝血功能等。初步評(píng)估病史采集神經(jīng)系統(tǒng)檢查實(shí)驗(yàn)室檢查EmergencyDepartmentEvaluationComputedTomography(CT)：使用CT掃描確定卒中類型和部位。DopplerSonography：對(duì)于疑似顱內(nèi)血管病變的患者，進(jìn)行經(jīng)顱多普勒超聲檢查。MagneticResonanceImaging(MRI)：對(duì)于某些特殊類型的卒中，如腦干或小腦卒中，MRI更為敏感。CTAngiography(CTA)orMagneticResonanceAngiography(MRA)：用于評(píng)估顱內(nèi)血管狀況。9字9字9字9字ImagingModalitiesinStrokeDiagnosis通過(guò)動(dòng)脈途徑給予溶栓藥物，溶解血栓，恢復(fù)血流。使用機(jī)械裝置將血栓從顱內(nèi)血管中取出。對(duì)于顱內(nèi)動(dòng)脈狹窄的患者，使用球囊擴(kuò)張血管，改善血流。動(dòng)脈溶栓機(jī)械取栓球囊擴(kuò)張成形術(shù)EndovascularProcedures對(duì)于某些特定類型的卒中，如顱內(nèi)出血，可能需要開顱手術(shù)清除血腫。開顱手術(shù)對(duì)于腦室出血的患者，進(jìn)行腦室穿刺引流，減輕顱內(nèi)壓。腦室穿刺引流SurgicalManagementSurgicalManagementRehabilitationPrograms:Theseprogramsaretailoredtotheindividual'sneedsandgoals,andmayincludeactivitiessuchasoccupationaltherapy,speechtherapy,andcognitivebehavioraltherapy.Rehabilitationprogramsaimtoimprovedailyfunctioningandqualityoflife.EmotionalandBehavioralSupport-CounselingandPsychotherapy:Post-strokeindividualsmayexperienceemotionalchallengessuchasdepression,anxiety,andadjustmentissues.Counselingandpsychotherapycanhelpindividualscopewiththesechallengesandpromoteapositivementalhealth.FamilyandCaregiverSupport:Strokesurvivorsoftenrequiresupportfromfamilymembersorcaregivers.Providingeducationand