关键词: 脑出血; 超急性期; 血压管理; 强化降压; 院前急救

Abstract: Intracerebral hemorrhage is an acute cerebrovascular disease with high disability and mortality rates, as well as a heavy disease burden. Elevated blood pressure during the hyperacute phase of intracerebral hemorrhage is independently associated with hematoma expansion and poor prognosis. Current research shows that intensive blood pressure reduction targeting 130-140 mmHg (1 mmHg=0.133 kPa) within 6 hours of intracerebral hemorrhage onset is safe and effective. Earlier intervention correlates with better outcomes, particularly when intensive antihypertensive therapy is initiated within 2 hours during ambulance transport, which can significantly improve long-term prognosis. However, the safety and efficacy of blood pressure management strategies for specific patients, such as those with ultra-high systolic blood pressure (≥220 mmHg) or large volume hematoma, as well as the comparison and preferred schemes of different antihypertensive agents, still need further exploration. Additionally, promoting the prehospital management mode of intracerebral hemorrhage, as well as the early identification of prehospital intracerebral hemorrhage, remains a clinical challenge. Glial fibrillary acidic protein shows high diagnostic value as a potential biomarker, and the application of mobile stroke units can significantly shorten the time from ambulance dispatch to the first brain imaging scan, providing a new approach for hyperacute management. Future research should focus on blood pressure management in specific patients, such as those with large volume hematoma and ultra-high baseline systolic blood pressure, exploration of novel biomarkers, and improvement of the prehospital to in-hospital coordinated care systems to further enhance survival rates and prognosis in intracerebral hemorrhage patients.

Key words: Intracerebral hemorrhage; Hyperacute phase; Blood pressure management; Intensive blood pressure reduction; Prehospital emergency care