急性脑卒中救治规范与流程英文

Title:ActStrokeTherapy:ProtocolandProcedures汇报人：文小库2024-01-11CONTENTSIntroductionPathophysiologyofStrokeStrokeTherapeuticsprotocolsStrokeProceduresPostStrokeCareandRehabilitationIntroduction01ActStrokereferstotherapidonsetoffocalneurologicaldeficit(s)causedbyfocalcerebralischemiaorintracerebralhemorrhage.Itisamedicalemergencythatrequiresimmediatetreatmenttominimizelong-termdisabilityandpreventdeath.DefinitionofActStrokeStandardizedprotocolforstroketreatmentensuresthatpatientsreceivepromptandeffectivecare,minimizingtheimpactofthestrokeontheirqualityoflife.Protocolshelptoensurethatallhealthcareprovidersinvolvedinstrokecarearefollowingbestpracticesandguidelines,leadingtoconsistentandhigh-qualitycare.ImportanceofStrokeTherapeuticsProtocolStrokeisaleadingcauseofdeathanddisabilityworldwide,affectingmillionsofpeopleeachyear.Theglobalburdenofstrokeisincreasing,duetopopulationaging,unhealthylifestyles,andtheriseinriskfactorssuchashypertension,diabetes,andobesity.GlobalBurdenofStrokePathophysiologyofStroke02由于动脉粥样硬化、血栓等原因导致脑血管阻塞，引起脑组织缺血、缺氧性坏死。突然出现的偏瘫、失语、感觉障碍等局灶性神经功能缺损症状。尽早恢复缺血区脑组织的血液供应，防止脑水肿、颅内压升高和继发性血栓形成。定义症状治疗原则IschemicStroke由于高血压、动脉瘤等原因导致脑血管破裂出血，引起脑实质内或脑室内出血。突然出现的头痛、呕吐、意识障碍、偏瘫等局灶性或全脑性症状。控制出血、降低颅内压、防止脑疝形成，同时积极处理原发病。定义症状治疗原则HemorhagicStroke由于动脉瘤、先天性脑血管畸形等原因导致脑实质内血管破裂出血，血液流入蛛网膜下腔。定义症状治疗原则突然出现的头痛、呕吐、意识障碍等全脑症状，常伴有颈项强直等脑膜刺激征。降低颅内压、缓解疼痛、防止继发性脑血管痉挛，同时积极处理原发病。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确保患者被快速识别为疑似卒中，并立即送往医疗机构。确保患者呼吸道畅通，必要时进行插管或使用呼吸机。在转运过程中监测并控制患者的血压和血糖水平。根据患者情况给予抗血小板或抗凝药物治疗。快速识别保持呼吸道通畅控制血压和血糖抗血小板和抗凝治疗PrehospitalManagement到达急诊室后，对患者进行初步评估，确定卒中类型和严重程度。详细了解患者病史，包括既往卒中史、高血压、糖尿病等。进行详细的神经系统检查，评估患者神经功能状况。进行必要的实验室检查，如血常规、凝血功能等。初步评估病史采集神经系统检查实验室检查EmergencyDepartmentEvaluationComputedTomography(CT)：使用CT扫描确定卒中类型和部位。DopplerSonography：对于疑似颅内血管病变的患者，进行经颅多普勒超声检查。MagneticResonanceImaging(MRI)：对于某些特殊类型的卒中，如脑干或小脑卒中，MRI更为敏感。CTAngiography(CTA)orMagneticResonanceAngiography(MRA)：用于评估颅内血管状况。9字9字9字9字ImagingModalitiesinStrokeDiagnosis通过动脉途径给予溶栓药物，溶解血栓，恢复血流。使用机械装置将血栓从颅内血管中取出。对于颅内动脉狭窄的患者，使用球囊扩张血管，改善血流。动脉溶栓机械取栓球囊扩张成形术EndovascularProcedures对于某些特定类型的卒中，如颅内出血，可能需要开颅手术清除血肿。开颅手术对于脑室出血的患者，进行脑室穿刺引流，减轻颅内压。脑室穿刺引流SurgicalManagementSurgicalManagementRehabilitationPrograms:Theseprogramsaretailoredtotheindividual'sneedsandgoals,andmayincludeactivitiessuchasoccupationaltherapy,speechtherapy,andcognitivebehavioraltherapy.Rehabilitationprogramsaimtoimprovedailyfunctioningandqualityoflife.EmotionalandBehavioralSupport-CounselingandPsychotherapy:Post-strokeindividualsmayexperienceemotionalchallengessuchasdepression,anxiety,andadjustmentissues.Counselingandpsychotherapycanhelpindividualscopewiththesechallengesandpromoteapositivementalhealth.FamilyandCaregiverSupport:Strokesurvivorsoftenrequiresupportfromfamilymembersorcaregivers.Providingeducationand