加拿大《最佳实践建议：卒中后抑郁、认知、疲劳》解读

2019年2月，加拿大卒中协会更新了第6版卒中患者《最佳实践建议：卒中后抑郁、认知、疲劳》（以下简称《建议》）。在2015年版《建议》的基础上，2019年版《建议》主要对卒中患者的抑郁、认知、疲劳方面的最佳实践建议、筛查和评估、治疗进行了补充与完善。相较于2015年版《建议》中的内容，2019年版《建议》对于证据不足的部分，增加了一个标题为“临床考虑”的新部分，代表基于较弱证据或专家共识的建议。2019年版《建议》表明预防性应用抗抑郁药物对一些卒中患者是有效的，此外还更新了筛查血管性认知障碍的评估工具及卒中后疲劳管理的相关信息。鉴于国内目前尚无专门针对卒中后患者抑郁、认知、疲劳方面的指南或共识，故笔者对2019年版《建议》进行解读，旨在为我国医护工作者进行卒中患者的规范化管理提供科学依据，改善卒中患者的照护结局。

Interpretation of the Canadian Stroke Best Practice Recommendations：Mood，Cognition and Fatigue following Stroke

In February 2019，the Canadian Stroke Consortium updated the 6th edition of Canadian Stroke Best Practice Recommendations（CSBPR） for Mood，Cognition and Fatigue following Stroke based on the 2015 edition，with supplements and improvements for the best practice recommendations，screening and assessment，and treatment for post-stroke depression，cognitive impairment，and fatigue.And a new section，named clinical considerations has been added to each area where evidence is insufficient，representing recommendations derived from weaker evidence and/or expert consensus-based practices.In the depression section，new evidence has been included，suggesting that prophylactic use of antidepressants is effective in some stroke patients.In addition，information on assessment tools for screening for vascular cognitive impairment and management of post-stroke fatigue has been updated.Given that there are no specific guidelines or consensus on post-stroke depression，cognitive impairment，and fatigue in China，we interpreted this edition of the CSBPR，hoping to provide a scientific basis for Chinese care providers to deliver standardized stroke management to improve the patient outcomes. Stroke；Depression；Cognition；Fatigue；Evidence-based practice；Canada