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《2012版美國(guó)動(dòng)脈瘤性蛛網(wǎng)膜下腔出血治療指南解讀》內(nèi)容簡(jiǎn)介
Purpose—The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH)。
Methods—A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. The guideline draft was reviewed by 7 expert peer reviewers and by the members of the Stroke Council Leadership and Manusc**t Oversight Committees. It is intended that this guideline be fully updated every 3 years.
《2012版美國(guó)動(dòng)脈瘤性蛛網(wǎng)膜下腔出血治療指南解讀》內(nèi)容預(yù)覽
自發(fā)性蛛網(wǎng)膜下腔出血的主要原因是腦動(dòng)脈瘤破裂,約占SAH的75%——80%.近年來(lái),隨著急救醫(yī)學(xué)進(jìn)展,越來(lái)越多aSAH患者在出血后得以存活。既往兩版指南經(jīng)過(guò)多年實(shí)踐已被廣大腦血管病醫(yī)生接受并采納。但世界各地針對(duì)aSAH的診治又進(jìn)行了多項(xiàng)臨床試驗(yàn),為制定新的指導(dǎo)性意見(jiàn)提供更為充分的論據(jù)。因此在上一版指南發(fā)布后3年即進(jìn)行再次修訂。
新版指南在針對(duì)aSAH的危險(xiǎn)因素防控、診斷、藥物及手術(shù)干預(yù)、術(shù)中麻醉管理、術(shù)后監(jiān)護(hù)及遠(yuǎn)期隨訪方面新增加總共31條指導(dǎo)意見(jiàn)。9條是針對(duì)既往推薦的修訂,另有22條推薦則是歸納近幾年最新研究成果后總結(jié)而成。這些新的推薦或指導(dǎo),為aSAH的1臨床診療提供了新的思路。本文對(duì)最新2012版aSAH治療指南進(jìn)行解讀,解釋新指南與以往指南的異同點(diǎn),以期為患者提供更好診治。
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