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脑卒中的内科并发症

Author
Koto Ishida, MD
Section Editor
Scott E Kasner, MD
Deputy Editor
John F Dashe, MD, PhD
Translators
王春雪, 主任医师，教授

引言

急性缺血性脑卒中的内科并发症很常见，常常会导致不良的临床结局。必须了解脑卒中的内科并发症发生率，以便采取预防策略并给予适当治疗。

脑卒中引起的主要内科并发症将总结在此；脑卒中的心脏和肺部并发症单独作更详细的讨论。 (参见“脑卒中的心脏并发症”和“脑卒中相关性肺部并发症及异常呼吸模式”)

脑卒中后癫痫参见其他专题。 (参见“成人癫痫处理概述”，关于‘脑卒中后癫痫发作’一节)

总论

已报道的脑卒中内科并发症发生率很高(表 1)[1-4]。一项前瞻性研究分析了甲磺酸替拉扎特治疗急性脑卒中的随机试验(randomized trial of tirilazad mesylate in acute stroke, RANTTAS)数据库的安慰剂组(n=279)，95%的患者至少出现一种内科并发症，24%的患者至少发生一种严重的(定义为迁延的、立即危及生命的或导致住院或死亡的)并发症[2]。最常见的内科严重并发症是肺炎(5%)、消化道出血(3%)、充血性心力衰竭(3%)和心搏骤停(2%)(表 2)。

约50%的脑卒中后死亡是由内科并发症所致。前瞻性收集的数据提示脑卒中后1周内的大多数死亡是缺血性脑卒中直接导致的，而此后的死亡主要是由内科并发症所致[2,5]。

                         

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-18.
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