[Therapeutic time window in ischemic stroke].
نویسندگان
چکیده
近年,脳梗塞の治療では心筋梗塞の治療と同様に早 期診断・早期治療の重要性が叫ばれ,心筋梗塞が “Heart Attack”と呼ばれ可急的速やかに治療され一命 をとりとめるように,脳梗塞も“Brain Attack”と捉え 同様に速やかに治療を行い,後遺症を最小限にくいと めることの重要性が認識されつつある.脳虚血が発症 して脳血流が遮断されると脳組織は数時間で不可逆性 の変化をきたし壊死に陥って梗塞となる.ひとたび脳 梗塞に罹患すると片麻痺や言語障害などの神経症候, 記憶・記銘力の低下や情緒障害などの精神症状,さら にQOLの低下や痴呆症などの後遺症に苦しむことに なり社会的生命を失うことにもなる. 近年CT(computed tomography),MRI・A(magnetic resonance imaging・angiography),SPECT(single photon emission computed tomography)や神経超 音波の画像診断機器の発達や生化学的,血液学的検査 の進歩により,脳卒中の病態が明らかにされ,診断も 的確となり脳梗塞に対しては血栓溶解療法が積極的に 取り入れられ,さらに低体温療法の応用や,フリーラ ジカルスカベンジャーを始めとする脳保護薬の投与な ど治療においても新時代を迎えている. 本稿では虚血性脳血管障害超急性期における治療可 能時間Therapeutic time windowの問題を中心に,そ の理論的根拠や治療上の問題点について述べる.
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ورودعنوان ژورنال:
- Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
دوره 67 2 شماره
صفحات -
تاریخ انتشار 2000