急性缺血性卒中非药物治疗的进展与展望:从机制、策略到证据OA

Acute ischemic stroke(AIS)is a leading cause of disability and death worldwide.Although vascular recanalization therapies,including intravenous thrombolysis and endovascular thrombectomy,can significantly improve the outcomes in eligible patients,the constraints of strict time windows and the phenomenon of futile recanalization have driven the search for adjunctive brain cytoprotection therapies independent of vascular recanalization therapies.Over the past decades,the consecutive negative results from clinical trials involving over a thousand brain cytoprotection drugs have partially shifted the research focus toward non-pharmacological treatments.This paper systematically summarizes the research progress of non-pharmacological treatments in brain cytoprotection for AIS,including Trendelenburg position,remote ischemic preconditioning,hyperbaric oxygen/normobaric hyperoxic oxygen,physical stimulation therapies,acupuncture,and hypothermia.It elaborates on the molecular physiological mechanisms,clinical intervention strategies,and the strength of existing evidence for each therapy,analyzes the current challenges in this field,and outlines future development strategies,with the aim of providing references for promoting the innovation and clinical translation of non-pharmacological treatments for AIS.