中国卒中营养标准化管理专家共识

正脑血管病是世界范围内致残率、致死率最高的疾病之一,也是疾病负担最重的疾病之一~([1-4])。根据最新流行病学研究报道,我国脑血管病的患病率、发病率和死亡率分别为1114.8/10万、246.8/10万和114.8/10万~([5])。脑血管病的发生给患者、家属、社会带来巨大的躯体、精神和经济负担~([3,6])。     

卒中“疾病全周期”康复

卒中全周期康复包含疾病全周期、分级诊疗全周期、参与人员全周期、不同地域之间全周期等四个方面。卒中全周期模式的提出对提高卒中诊疗水平、实施分级诊疗策略、人员功能定位、消除地区间医疗资源的不平衡提供了建设性意见。疾病全周期能让我们更好地了解卒中不同分期并且给予针对性康复,使患者的功能预后实现最优化。本文就疾病全周期康复策略和措施进行阐述。     

卒中相关性肺炎诊治中国专家共识（2019更新版）

<正>卒中相关性肺炎(stroke-associated pneumonia,SAP)的概念由Hilker于2003年首先提出,是卒中后致死的重要危险因素之一~([1-2]),并且增加了住院时间及医疗费用~([3]),给家庭和社会带来了沉重的负担。既往国内外对SAP这一概念缺乏统一的认知,诊断标准也存在明显差别~([4]),这可能会导致临床工作中对SAP预防不到位、诊断不及时、抗感染治疗不合理,最终患者预后不佳。为提高对SAP的认识,由我国神经内科、呼吸科、感染科及重症医学科等多学科专家于2009年成立专家组,共同     

卒中相关睡眠障碍评估与管理中国专家共识2023

卒中相关睡眠障碍（stroke-related sleep disorders,SSD）是卒中后常见症状,且易被忽视。2019年,北京神经内科学会联合相关专业学会及相关领域专家制定并发表了《卒中相关睡眠障碍评估与管理中国专家共识》。北京神经内科学会汇集各方意见和建议,结合最新临床研究成果,完成了“共识”2023年更新版。2023版“共识”主要聚焦有循证医学证据的SSD评估及治疗方法的新进展,并增加了一些循证证据较少的睡眠障碍亚型治疗方面的专家推荐意见,增加其临床实用性及可操作性,有效指导临床医师规范诊疗SSD。     

卒中后认知障碍管理专家共识2021

2020年发布的《中国卒中报告》显示:我国卒中患病率为1114.8/10万,年发病率为246.8/10万,死亡率为149.49/10万[1-2]。在全球范围内,我国已经成为卒中终身风险最高和疾病负担最重的国家[3]。其中,约1/3的卒中患者会经历卒中后认知障碍(post-stroke cognitive impairment,PSCI)[4],生活质量及生存时间受到严重影响,是目前卒中疾病负担的重要原因,并成为当下国际卒中研究的热点和临床干预的重点。     

血小板活化因子受体拮抗剂治疗缺血性卒中的中国专家共识

缺血性卒中具有高发病率、死亡率、致残率和复发率的特点,患者年致死/残疾率高达33.4%~33.8%[1],给社会、家庭和患者带来沉重的负担和巨大痛苦,对其进行有效诊治意义重大。既往针对缺血性卒中的特异性治疗主要包括溶栓、抗血小板、抗凝等改善脑循环的抗栓治疗[2]。其中抗血小板药物能够抑制血栓形成,是缺血性脑血管疾病的首要治疗措施。但目前抗血小板治疗存在一些不足,如阿司匹林和氯吡格雷疗效的个体差异、呼吸道反应、胃肠道反应、出血倾向、过敏反应等[3-4]。此外,卒中发病机制复杂,除了缺血导致的组织坏死,还涉及卒中后的免疫异常、缺血再灌注损伤等多种重叠损伤机制,需要给予抗炎、神经保护等综合治疗措施。然而,目前对卒中的发病机制进展认识有限,对卒中后免疫调节、预防缺血再灌注损伤、神经保护等治疗尚缺乏有效措施[5-6]。     

卒中相关非运动症状多学科管理专家共识

<正>随着脑血管病治疗手段的精进,中国卒中患者的死亡率不断下降,越来越多的卒中患者得以长期生存。卒中相关非运动症状给长期生存的卒中患者带来很多困扰,严重影响患者的预后和生活质量。卒中相关非运动症状需要多学科团队共同参与管理。北京脑血管病防治协会成立《卒中相关非运动症状多学科管理专家共识》（以下简称《共识》）编写委员会,组织多学科专家编写《共识》,形成对卒中相关非运动症状临床诊疗和管理的建议,以期更加规范地服务于卒中患者。     

阿加曲班治疗急性缺血性卒中中国专家共识2021

卒中是严重危害人类健康的疾病之一,具有高发病率、高残疾率、高死亡率和高复发率的特点,现已成为我国居民(尤其是农村人群)死亡的首要病因,其中急性缺血性卒中(acute ischemic stroke,AIS)约占70％[1-2].目前AIS的治疗原则是在治疗时间窗内进行静脉溶栓和(或)血管内治疗(endovascular...     

Expert Consensus on the Care and Management of Patients with Cognitive Impairment in China

The cognitive disease consensus was prepared by panels of health and public representatives based on actual clinical practice in Geriatric Departments in Chinese hospitals and a systematic literature review. This consensus reflects the medical knowledge accumulated by those experts and provides information about professional medical care and advice.A multidisciplinary panel of specialists(neurologists,psychiatrists, and nursing specialists) reports an expert consensus on the medical knowledge accumulated from those experts and provides information about professional medical care and advice. The recommendations focus on the care and management of older adults with mild cognitive impairment,the objectives and methods of maintaining cognition and training, the assessments and measures of daily care for patients at different stages of dementia, the assessments and coping strategies for the behavioral and psychological symptoms of dementia, principles and suggestions for an appropriate living environment, arrangements for recreational activities, the care and management of patients with endstage dementia, and suggestions for addressing stress in caregivers.     

脑小血管病转化医学研究中国专家共识

正脑小血管病(cerebral small vessel disease,CSVD)是临床常见的一类年龄相关脑血管疾病,由各种因素影响脑内小动脉、微动脉、毛细血管、微静脉和小静脉导致的一系列临床、影像、病理综合征。CSVD可急性起病,表现为脑实质出血或者缺血性卒中;多数则隐匿起病,缓慢发展,临床上通常缺乏特异性表现,患者可出现认知功能下降(血管性痴呆)、平衡步态异常、精神情感改变、尿失禁及     

Electroconvulsive Therapy Practice Changes in Older Individuals Due to COVID-19: Expert Consensus Statement

The ubiquitous coronavirus 2019 (COVID-19) pandemic has required healthcare providers across all disciplines to rapidly adapt to public health guidelines to reduce risk while maintaining quality of care. Electroconvulsive therapy (ECT), which involves an aerosol-generating procedure from manual ventilation with a bag mask valve while under anesthesia, has undergone drastic practice changes in order to minimize disruption of treatment in the midst of COVID-19. In this paper, we provide a consensus statement on the clinical practice changes in ECT specific to older adults based on expert group discussions of ECT practitioners across the country and a systematic review of the literature. There is a universal consensus that ECT is an essential treatment of severe mental illness. In addition, there is a clear consensus on what modifications are imperative to ensure continued delivery of ECT in a manner that is safe for patients and staff, while maintaining the viability of ECT services. Approaches to modifications in ECT to address infection control, altered ECT procedures, and adjusting ECT operations are almost uniform across the globe. With modified ECT procedures, it is possible to continue to meet the needs of older patients while mitigating risk of transmission to this vulnerable population.     

卒中后认知障碍管理专家共识

正2016年《中国脑卒中防治报告》报道:我国现有卒中患者7000万人,不同地区卒中年龄标准化患病率约260~719/10万人,每年新发卒中200万人,即每12 s新发1例卒中;而每年因卒中致死达165万人,即每21 s就有一人死于卒中,每年因卒中致死者占所有死亡原因的22.45%~[1]。2016年5月中国脑卒中大会的报告显示:卒中导     

症状性颅内动脉粥样硬化性狭窄血管内治疗中国专家共识2018

正颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)是导致缺血性卒中重要原因之一,不同人种之间差异明显,亚裔人群中颅内动脉粥样硬化性卒中患者占30%～50%,北美人群中仅有8%～10%~([1-2])。2014年中国症状性颅内大动脉狭窄与闭塞研究(Chinese Intracranial Atherosclerosis,CICAS)结果显示中国缺血性卒中或短暂性脑缺血发作(transient ischemic attack,TIA)患者中颅     

卒中患者吞咽障碍和营养管理的中国专家共识（2013版）

卒中后吞咽障碍及营养不良是卒中常见的并发症,显著增加卒中患者的病死率,严重影 响卒中患者生活质量,并延长住院时间,增加治疗费用。自2007年《中国卒中患者营养管理的专家共 识》（以下简称共识）[1]颁布以来,临床医生逐渐增加了对卒中患者吞咽障碍及营养风险管理的意识, 但临床实践中还存在诸多实际困难和认识误区。在前期工作的基础上,结合新近发表的循证医学证 据和国际指南,并结合中国国情及医疗现状,对旧版《共识》进行修订,并更名为《卒中患者吞咽障 碍和营养管理的中国专家共识》,以期提高临床医生的认识水平,进一步规范临床实践。本共识的 推荐意见分级采用牛津循证医学中心临床证据水平分级和推荐级别（表1）[2]。     

2007年颈动脉支架成形术专家共识

序言本共识文件由美国心脏病学院基金会(ACCF)临床专家共识文件(CECD)专项工作组发起,心血管造影和介入学会(SCAI)、血管医学和生物学协会(SVMB)、介入放射学会(SIR)以及美国介入与治疗神经放射学会(ASITN)共同完成。本文件旨在提供有关颈动脉支架成形术(CAS)现状的权威观点。     

急性缺血性脑卒中急诊急救中国专家共识2018

正1前言急性卒中是一种发病率高、致残率高、病死率高、复发率高及并发症多的疾病~([1-2])。据统计,2013年中国卒中的年龄标化患病率为1114.8/10万,发病率为246.8/10万,死亡率为114.8/10万~([3])。目前,急性缺血性卒中(acute ischemic stroke,AIS)最有效的治疗方法是时间窗内给予血管再通治疗,包括重组组织型纤溶酶原激活剂     

Polyanalgesic Consensus Conference 2012: Recommendations for the Management of Pain by Intrathecal (Intraspinal) Drug Delivery: Report of an Interdisciplinary Expert Panel

Introduction: The use of intrathecal (IT) infusion of analgesic medications to treat patients with chronic refractory pain has increased since its inception in the 1980s, and the need for clinical research in IT therapy is ongoing. The Polyanalgesic Consensus Conference (PACC) panel of experts convened in 2000, 2003, and 2007 to make recommendations on the rational use of IT analgesics based on preclinical and clinical literature and clinical experiences. Methods: The PACC panel convened again in 2011 to update the standard of care for IT therapies to reflect current knowledge gleaned from literature and clinical experience. A thorough literature search was performed, and information from this search was provided to panel members. Analysis of published literature was coupled with the clinical experience of panel members to form recommendations regarding the use of IT analgesics to treat chronic pain. Results: After a review of literature published from 2007 to 2011 and discussions of clinical experience, the panel created updated algorithms for the rational use of IT medications for the treatment of neuropathic pain and nociceptive pain. Conclusions: The advent of new algorithmic tracks for neuropathic and nociceptive pain is an important step in improving patient care. The panel encourages continued research and development, including the development of new drugs, devices, and safety recommendations to improve the care of patients with chronic pain.