Spontaneous Intracerebral Hemorrhage: Management.
Spontaneous Intracerebral Hemorrhage: Management.
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DOI：
10.5853/jos.2016.01935
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发表时间：
2017-01
影响因子：
8.2
通讯作者：
Bae HJ
中科院分区：
文献类型：
--
作者：
Kim JY;Bae HJ
自发性非创伤性脑出血（ICH）仍然是全世界死亡率和发病率的重要原因。为了改善ICH的破坏性过程，在过去10年中进行了各种内科和外科干预的临床试验。最近的大规模临床试验报告称，早期强化降压可能是ICH的安全可行策略，并提出了收缩压的安全目标范围。虽然已经开发了与华法林和非维生素K拮抗剂口服抗凝剂相关的新药物治疗来治疗ICH，但最近的试验无法证明手术干预对死亡率和功能结局的总体有益影响。然而，一些ICH患者可能在特定临床背景和/或特定时间从手术治疗中获益。此外，微创手术排空方法的临床试验正在进行中，可能会提供积极的证据。在了解ICH管理的现行指南后，临床医生可以进行适当的治疗并尝试改善ICH的临床结局。本综述的目的是帮助ICH的内科和外科治疗决策。
Spontaneous non-traumatic intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Recent large-scale clinical trials have reported that early intensive blood pressure reduction can be a safe and feasible strategy for ICH, and have suggested a safe target range for systolic blood pressure. While new medical therapies associated with warfarin and non-vitamin K antagonist oral anticoagulants have been developed to treat ICH, recent trials have not been able to demonstrate the overall beneficial effects of surgical intervention on mortality and functional outcomes. However, some patients with ICH may benefit from surgical management in specific clinical contexts and/or at specific times. Furthermore, clinical trials for minimally invasive surgical evacuation methods are ongoing and may provide positive evidence. Upon understanding the current guidelines for the management of ICH, clinicians can administer appropriate treatment and attempt to improve the clinical outcome of ICH. The purpose of this review is to help in the decision-making of the medical and surgical management of ICH.