急性脑梗死治疗体位的研究进展  

Advances in research on treatment positions for acute cerebral infarction

作　　者：鲁国[1] 李烁 闫福岭[2] Lu Guo;Li Shuo;Yan Fuling(Department of Neurology, Dezhou People＇s Hospital, Dezhou 253000, China;Department of Neuralogy, Zhongda Hospital, Southeast University, Nanjing 210009, China)

机构地区：[1]山东省德州市人民医院神经内科,253000 [2]东南大学附属中大医院神经内科,南京210009

出　　处：《中华神经医学杂志》2018年第5期537-540,共4页Chinese Journal of Neuromedicine

基　　金：山东省医药卫生科技发展计划项目（2017WS537）

摘　　要：急性脑梗死的治疗体位包括平卧位、侧卧位和头高位。近年来治疗体位研究的争议多集中在头高位和平卧位的选择方面，研究表明头高位可能降低颅内压并减少肺炎发生，而平卧位却可能增加脑血流灌注及改善梗死区氧合指数从而增加溶栓再通率，因此，目前仍然没有明确的临床证据表明何种治疗体位是急性脑梗死治疗和康复的最佳选择。本文主要围绕急性脑梗死常用的治疗体位的概念．及治疗体位对脑血流灌注、动脉血氧饱和度、颅内压和肺炎发生的影响以及其可能的影响方式进行综述。以期为临床上急性脑梗死治疗体位的选择提供参考。Postural treatment for acute cerebral infarction involves supine position, lateral position and head elevation. In recent decades, controversy arises concerning determination between supine position and head elevation. Head elevation may decrease intracranial pressure and reduce incidence of pneumonia while supine position may strengthen cerebral perfusion and improve oxygenation indexes in the infarction area to promote recanalization. There has been no clear clinical evidence to determine the best treatment or rehabilitation position for patients with acute cerebral infarction. This article, hoping to provide references for clinical choice of treatment position, reviews the concept of postural treatment for patients with acute anterior circulation infarction, impacts of position on cerebral blood flow, arterial oxygen saturation, intracranial pressure and incidence of pneumonia, and possible ways of the impacts as well.

关 键 词：急性脑梗死 治疗体位 头高位 平卧位 

分 类 号：R743.3[医药卫生—神经病学与精神病学]