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2013年脑卒中指南:修改的和新的建议摘要(第三部分:介入治疗后)
原作者: Feng Xiao, MD (肖锋) 文章来源: 中华急诊医学杂志编辑部 发布日期:2013-03-14

Title: 2013 Stroke Guidelines: Revised and New Recommendations (Part 3: Post-intervention)
题目:2013年脑卒中指南:修改的和新的建议摘要(第三部分:介入治疗后)


9. Anticoagulation 抗凝治疗
The usefulness of argatroban and other thrombin inhibitors in acute ischemic stroke is not well established.
阿加曲班及其它凝血酶抑制剂在急性缺血性脑卒中中的应用效果还没有很好建立。
10. Antiplatelet Agents 抗血小板药
Aspirin remains the only antiplatelet agent for which data support use in acute stroke, although trials with other agents are in progress.
阿司匹林还是唯一的一个有证据支持其在急性脑卒中使用的抗血小板药。其它的药物还在试验中。
11. Volume Expansion, Vasodilators, and Induced Hypertension 扩容,血管扩张剂,和诱导性高血压
Vasodilators are not recommended; Consider vasopressors with symptomatic hypotension; Efficacy of drug-induced hypertension and hemodilution by volume (i.e., albumin) not well established.
不建议使用血管扩张剂;如有症状性低血压可考虑升压药;药物诱发的高血压和容积性血液稀释(白蛋白)的效果还不明确。
12. Neuroprotection and Surgery 神经保护和手术
Hyperbaric oxygen is not recommended, except for air embolization; Continue statins; Transcranial near-infrared laser therapy and other neuroprotective drugs not recommended
不建议用高压氧,除非是气体栓塞;继续用他汀类药物;不建议用经颅近红外激光疗法和其它的神经保护药。
13. Hospital Admission and Treatment 住院治疗
Nasogastric, nasoduodenal, or percutaneous endoscopic gastrostomy tube feeding should be used in patients unable to take liquids or solid food.
如病人不能吃液体或固体食物,要考虑用鼻胃管,鼻十二指肠管,或经皮内窥镜胃造瘘管。
Nasogastric feeding is preferred to percutaneous endoscopy gastrostomy tube feeding until 2-3 weeks post-stroke in patients who cannot take oral liquid and food.
鼻胃管在脑卒中后2-3周内不能从口进液体或固体的病人要优于经皮内窥镜胃造瘘管。
In patients in whom anticoagulation is contraindicated for DVT prophylaxis, consider external compression devices.
防止DVT的发生,如不能用抗凝药,可考虑用体外压缩设备。
Routine nutritional supplements and prophylactic antibiotics have not been shown to be beneficial.
常规营养补充和预防性抗菌素应用还没有显示出有益的作用。
14. Treating Neurologic Complications 神经合并症的处理
Aggressive medical treatment has been previously recommended in deteriorating patients with malignant edema due to a large cerebral infarction; however, the usefulness of this approach is not well established.
虽然过去建议对由于大面积梗塞造成的恶性脑水肿要进行积极药物治疗,但这些方法的效果还不清楚。
Decompressive surgical evacuation of a space-occupying ce