卒中相关非运动症状多学科管理专家共识

本著作聚焦于卒中后眩晕平衡、情绪精神症状、认知障碍、营养及消化系统症状、睡眠障碍、感觉异常、呼吸循环症状、生活质量等卒中后非运动症状，以及中医中药在管理卒中后非运动症状上的应用。旨在提高临床上对卒中后非运动症状的认识，指导卒中非运动症状的管理，对改善卒中患者生活质量具有重要意义。

赵性泉，主任医师，教授，博士研究生导师，首都医科大学附属北京天坛医院神经病学中心主任，党总支书记。 王春雪，主任医师，教授，博士生导师。北京天坛医院神经精神医学与临床心理科主任，北京天坛医院睡眠医学中心主任。

第一章　卒中相关前庭症状 ··································· 1 一、卒中相关前庭症状概念的产生及背景 ···············1 二、卒中发生前的前庭症状 ·································2 三、卒中急性期的前庭症状 ·································4 四、卒中后前庭症状的演化情况 ···························7 五、卒中共病因素所致的前庭症状 ························9 六、有助于前庭症状病因鉴别的检查 ··················· 11 七、卒中相关前庭症状的评估 ···························· 13 八、总结 ······················································· 15 九、推荐建议 ················································· 15 第二章　卒中后情绪及精神症状 ····························18 一、卒中后抑郁 ·············································· 19 二、卒中后焦虑 ·············································· 23 三、卒中后疲劳 ·············································· 26 四、卒中后淡漠 ·············································· 29 五、卒中后谵妄 ·············································· 32 六、推荐建议 ················································· 34 七、附表 ······················································· 36 第三章　卒中相关认知障碍 ··································51 一、流行病学 ················································· 52 二、病理机制 ················································· 53 三、危险因素 ················································· 55 四、诊断 ······················································· 56 五、评估 ······················································· 58 六、预测 ······················································· 60 七、治疗 ······················································· 62 八、预防 ······················································· 66 九、推荐建议 ················································· 69 十、附表 ······················································· 70 第四章　卒中相关营养标准化管理 ·························82 一、背景及相关概念 ········································ 82 二、卒中后营养不良标准化管理 ························· 84 三、推荐建议 ················································· 95 第五章　卒中相关睡眠障碍 ································ 104 一、卒中相关失眠 ··········································105 二、卒中相关睡眠呼吸障碍 ······························107 三、卒中相关异态睡眠 ···································· 111 四、卒中相关日间思睡 ···································· 113 五、 卒中相关不宁腿综合征 /睡眠中周期性肢体运动 ················································ 115 六、卒中相关昼夜节律相关睡眠 -觉醒障碍 ········· 118 七、推荐建议 ················································ 119 八、附表 ······················································120 第六章　卒中后疼痛的诊断和治疗 ······················· 129 一、卒中后疼痛概述 ·······································129 二、中枢性卒中后疼痛 ····································132 三、痉挛性疼痛 ·············································137 四、卒中后肩痛 ·············································139 五、复杂性区域疼痛综合征 ······························142 六、卒中后头痛 ·············································146 七、结论 ······················································147 八、推荐建议 ················································148 九、附表 ······················································149 第七章　卒中相关呼吸循环症状 ·························· 153 一、卒中相关性肺炎 ·······································153 二、卒中后心脏损伤 ·······································160 三、推荐建议 ················································171 第八章　卒中相关皮肤病变 ································ 175 一、同时存在卒中与皮肤病的系统性疾病 ············175 二、可以出现卒中的神经皮肤疾病 ·····················180 三、卒中常见的皮肤共病 ·································184 四、卒中常见的继发性皮肤问题 ························191 五、推荐建议 ················································192 第九章　卒中非运动症状的中医管理 ···················· 196 一、眩晕失衡 ················································196 二、情绪精神症状 ··········································204 三、认知障碍与痴呆 ·······································210 四、呃逆 ······················································217 五、便秘 ···········································