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脑梗死或短暂性脑缺血发作(TIA)紧急干预后主要目标是对今后脑缺血的二级预防和首次缺血事件引起的并发症预防。诊断性评价的意义在于:①明确可能的发病机制(心源性栓塞、颅外和颅内血管的大血管病变、小血管病变、凝血功能障碍或隐源性):②明确危险因素(高血压、高脂血症、吸烟、糖尿病);③完成成本效率和安全性方面的评价。我们提出了贯序的脑梗死或TIA的诊断评价步骤,以求尽可能完善诊断,使患者的花费和可能受到的损害降至最低,并提供改善处理方案的信息。这套系统的评价方案集中在6个重要的问题上:①这些症状与脑梗死或TIA(与非缺血性病理改变相对)相符吗?②缺血部位在哪里?③脑梗死和TIA的病因和发病机制可能是什么?④每一种可能病因的患病率是多少?⑤现有的针对病因的治疗方法是什么?⑥哪些辅助检查有助于病因评价?
The main goal after emergency intervention of cerebral infarction or transient ischemic attack (TIA) is secondary prevention of future cerebral ischemia and prevention of complications caused by the first ischemic event. Diagnostic evaluation of the significance lies in: ① clear possible pathogenesis (cardiogenic embolism, extracranial and intracranial vascular macrovascular disease, small vessel disease, coagulation dysfunction or cryptogenic): ② clear risk factors (hypertension , Hyperlipidemia, smoking, diabetes); ③ to complete the cost-effectiveness and safety aspects of the evaluation. We propose sequential diagnostic evaluation of cerebral infarction or TIA to try to perfect the diagnosis as much as possible, to minimize patient costs and possible damage, and to provide information to improve treatment options. The evaluation of the system focuses on six important questions: (1) Does the symptom be consistent with cerebral infarction or TIA (as opposed to nonischemic pathology)? Where is the ischemic site? What are the causes of cerebral infarction and TIA? And the pathogenesis may be? ④ What is the prevalence of each possible cause? ⑤ What is the existing treatment for the cause? ⑥ Which auxiliary tests contribute to the etiology?