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急性缺血性脑卒中机械取栓术后血压管理研究进展
张小曦,杨鹏飞,张永巍,刘建民*
0
(海军军医大学(第二军医大学)第一附属医院脑血管病中心, 上海 200433
*通信作者)
摘要:
机械取栓是大血管闭塞急性缺血性脑卒中(AIS)患者的有效治疗方法,但是超过半数的患者临床预后不佳。术后高灌注导致的颅内出血转化与AIS机械取栓术后临床预后恶化密切相关,而低灌注可能会导致梗死进一步加重,因此,加强术后血压管理、平衡好颅内高灌注与低灌注风险对于改善患者预后具有重要意义。ENCHANTED2/MT研究旨在探讨机械取栓后强化降压治疗的效果,一经开展即在国内外脑血管病领域引起广泛关注。本文综合目前脑血管病领域最重要的研究结果,对AIS机械取栓后血压管理的研究进展进行解读。
关键词:  急性缺血性脑卒中  血压管理  机械取栓  个体化治疗
DOI:10.16781/j.CN31-2187/R.20230146
投稿时间:2023-03-28修订日期:2023-07-10
基金项目:上海申康医院发展中心临床研究关键支撑项目(SHDC2020CR6014),上海市扬帆计划(20YF1448000).
Post-thrombectomy blood pressure management of acute ischemic stroke: research progress
ZHANG Xiaoxi,YANG Pengfei,ZHANG Yongwei,LIU Jianmin*
(Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Mechanical thrombectomy is an effective treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion, but more than half of the patients have poor clinical prognosis. The transformation of intracranial hemorrhage caused by postoperative high perfusion is closely related to the deterioration of clinical prognosis after AIS mechanical thrombectomy, and low perfusion may lead to further aggravation of infarction. Therefore, strengthening postoperative blood pressure management and balancing the risks of intracranial high perfusion and low perfusion are of great significance for improving patient prognosis. ENCHANTED2/MT research is to explore the effect of intensive antihypertensive therapy after mechanical thrombectomy, and it immediately attracts widespread attention in the field of cerebrovascular diseases at home and abroad. This article summarizes the most important research in the field of cerebrovascular diseases, and interprets the research progress in blood pressure management after AIS mechanical thrombectomy.
Key words:  acute ischemic stroke  blood pressure management  mechanical thrombectomy  individualized therapy