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大核心梗死缺血性卒中血管内治疗术后护理进展

Progress in postoperative nursing care for patients with acute ischemic stroke associated with large-core infarction undergoing endovascular therapy

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临床上,约1/4的大血管闭塞性急性缺血性脑卒中病人存在大的梗死核心.这类病人以减轻脑水肿、缓解颅内压升高、防止出血转化和其他继发性损伤为主要治疗原则.由于出血转化和再灌注损伤的风险较高,血管内治疗对伴有大核心梗死的急性缺血性脑卒中的作用尚存有争议.最近,有研究报道血管内治疗对伴大核心梗死的缺血性卒中病人的预后有益处,但是术后存在继发性脑损伤的风险,因此,需要细致的护理以改善其预后.良好的护理对优化血压控制、减轻继发性脑损伤、控制脑水肿和神经保护具有重要作用.本文就伴大核心梗死的缺血性卒中病人血管内治疗术后护理进展作一综述.
Clinically,approximately one-fourth of patients with large vessel occlusion acute ischemic stroke present with large infarct cores. The main treatment principles for these patients are to alleviate brain edema,relieve elevated intracranial pressure,prevent hemorrhagic transformation,and other secondary injuries. Due to the high risks of hemorrhagic transformation and reperfusion injury,the efficacy of endovascular therapy for patients with acute ischemic stroke associated with large core infarction remains controversial. Recently,studies have reported that endovascular therapy is beneficial for the prognosis of patients with ischemic stroke accompanied by large core infarction;however,there is a risk of secondary brain injury after the operation. Therefore,meticulous nursing is required to improve their prognosis. Excellent nursing plays a crucial role in optimizing blood pressure control,reducing secondary brain injury,controlling brain edema,and providing neuroprotection. This article presents a review on the progress of postoperative nursing for patients with ischemic stroke accompanied by large core infarction after endovascular therapy.

Acute ischemic strokeLarge core infarctionEndovascular therapyNursing care

沈刘艳、张静、邬幼萍

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214000江苏无锡,联勤保障部队第九〇四医院神经外科

急性缺血性脑卒中 大核心梗死 血管内治疗 护理

2024

中国临床神经外科杂志
广州军区武汉总医院

中国临床神经外科杂志

CSTPCD
影响因子:0.781
ISSN:1009-153X
年,卷(期):2024.29(7)