中国卒中杂志2025，Vol.20Issue(7)：797-801,5.DOI:10.3969/j.issn.1673-5765.2025.07.001
卒中院前急救与血压管理的挑战与突破:从现状到未来
Challenges and Breakthroughs in Prehospital Emergency Care and Blood Pressure Management for Stroke:Current Status and Future Directions
陈晨 1刘飞凤 1熊昕丽 2汤跃宇 2李刚1
作者信息
- 1. 上海 200123 同济大学附属东方医院神经内科||同济大学脑血管病研究中心||同济大学附属东方医院中澳神经病学临床研究合作中心
- 2. 上海 200123 同济大学附属东方医院神经内科
- 折叠
摘要
Abstract
Stroke,as the leading cause of death among Chinese residents,has an emergency treatment effect highly dependent on ultra-early intervention.However,current prehospital emergency care for stroke mainly focuses on recognition and transportation,lacking targeted treatment measures.Blood pressure management is one of the key factors affecting the prognosis of stroke patients.Yet,in prehospital emergency care for stroke,blood pressure management faces significant challenges due to the different pathological mechanisms of ischemic stroke and hemorrhagic stroke:ischemic stroke needs to maintain cerebral perfusion pressure to protect the ischemic penumbra,while hemorrhagic stroke requires rapid blood pressure reduction to suppress hematoma expansion.The latest research evidence indicates that in the absence of stroke subtype diagnosis,prehospital intensive blood pressure reduction[with a systolic blood pressure target of 130-140 mmHg(1 mmHg=0.133 kPa)]not only fails to improve the prognosis of stroke patients but also exerts opposite effects on the prognosis of patients with hemorrhagic stroke and ischemic stroke,highlighting the critical importance and urgency of prehospital stroke subtype diagnosis.Currently,there is a lack of low-cost and easily implementable methods for prehospital stroke subtype diagnosis.This review summarizes the current status and recent advances in prehospital blood pressure management and stroke subtype diagnosis,aiming to provide references for future directions in this field.关键词
卒中/院前急救/血压管理/快速诊断技术Key words
Stroke/Prehospital emergency care/Blood pressure management/Fast diagnosis technique分类
医药卫生引用本文复制引用
陈晨,刘飞凤,熊昕丽,汤跃宇,李刚..卒中院前急救与血压管理的挑战与突破:从现状到未来[J].中国卒中杂志,2025,20(7):797-801,5.
