急性脑出血早期血肿扩大止血治疗研究进展

摘要/Abstract

摘要：

既往研究证实，脑出血后血肿扩大与早期神经功能恶化密切相关，往往预示着不良临床结局。血肿扩大是脑出血具有前景的治疗靶点。若不加筛选地对所有脑出血患者进行止血治疗，不但不能改善功能结局，反而可能增加动脉血栓栓塞不良事件风险。计算机断层扫描血管造影（computed tomography angiography，CTA）点样征是血肿扩大和不良预后安全有效的预测指标。应用点样征筛选血肿扩大高风险患者，并选用安全、经济的止血药物进行个体化止血治疗，对于遏制患者早期病情恶化及改善预后有重要意义。

文章导读： 本文着眼于脑出血早期血肿扩大这一动态变化现象，介绍了急性脑出血止血治疗的研究现状和未来展望。急性脑出血早期止血治疗的探索有望改变脑出血临床治疗策略匮乏的现状。

关键词: 脑出血; 血肿扩大; 止血治疗; 点样征; 预后

Abstract:

Past studies have evidenced the strong relationship between hematoma enlargement after intracerebral hemorrhage (ICH) and early neurological deterioration, indicating poor clinical outcome. Hematoma enlargement is a potentially important therapeutic target. However, hemostatic therapy to all ICH patients indiscriminately does not improve functional outcome, but increases the incidence of arterial thromboembolic adverse events (TAE). Contrast extravasation on CT angiography, namely “spot sign”, predicts hematoma expansion and poor prognosis in acute intracerebral hemorrhage with safety and efficacy. It plays a central role in prevention of early deterioration and improvement of functional outcome to rely on the “spot sign” for the selection of patients to receive early hemostatic therapy with safe and economical hemostatic agents. This study summarizes the related research situation and trend, so as to provide reference for clinical practice.

Key words: Intracerebral hemorrhage; Hematoma enlargement; Hemostatic therapy; Spot sign; Prognosis

陈瑶枝，刘丽萍. 急性脑出血早期血肿扩大止血治疗研究进展[J]. 中国卒中杂志, 2016, 11(05): 408-413.

CHEN Yao-Zhi, LIU Li-Ping. Hemostatic Therapy on Preventing Hematoma Enlargement in Acute Intracerebral Hemorrhage[J]. Chinese Journal of Stroke, 2016, 11(05): 408-413.

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