|
卵圆孔未闭引发缺血性脑卒中 |
|
的指征为:a.分流大于50个气泡。b.合并房间隔瘤。c.多发性脑卒中。d.卒中前有乏氏动作的诱发因素。上述4种情况必须有2个才能考虑较积极的治疗[10]。
5 小结
不明原因脑卒中应考虑PFO和逆向栓塞的可能性。经食道心超发现PFO较经胸者敏感,对50岁以下原因不明的脑卒中患者有条件可考虑作为一项常规检查,并需进一步探查有否DVT存在。治疗方面可考虑用华法林3~6月后改为长期用阿司匹林治疗。经抗凝治疗后仍有卒中复发者可考虑经皮PFO封堵术[1]。
【参考文献】 [1]Kizer J R, Devereux R B, Clinical practice. Patent foramen ovale in young adults with unexplained stroke[J]. N Engl J Med, 2005,353:2361-2372.
[2]Leys D, Bandu L, Henon H, et al. Clinical outcome in 287 consecutive young adults(15 to 45 years) with ischemic stroke[J]. Neurology, 2002,59:26-33.
[3]Handke M, Harloff A, Olschewiski M, et al. Patent foramen ovale and cryptogenic stroke in older patients[J]. N Eng J Med, 2007, 357:2262-2268.
[4]Harloff A, Hanke M, Reinhard M, et al. Therapentic strategies after examination by transesonhageal echocardiography in 503patients with ischemic stroke[J]. Stroke, 2006,37:859-864.
[5]Hirsh J. Diagnosis of venous thrombosis and pulmonary embolism[J]. Am J Cardiol, 1990,65:45c_49c.
[6]Stollberger C, Slany J, Schuster I, et al. The prevalence of deep venous thrombosis in patients with suspected paradoxical embolism[J]. Ann Intern Med, 1994,12:347.
[7]Cramer SC, Rordorf G, Maki JH, et al. Increased pelvic v上一页 [1] [2] [3] 下一页 上一个医学论文: 低通气综合征的诊治进展 下一个医学论文: 新型抗生素有效抑制耐药细菌
|
|
|