New avenues for treatment of intracranial hemorrhage.
New avenues for treatment of intracranial hemorrhage.
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DOI：
10.1007/s11936-013-0277-y
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发表时间：
2014-01-01
影响因子：
--
通讯作者：
Selim, Magdy H
中科院分区：
文献类型：
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作者：
Sonni, Shruti;Lioutas, Vasileios-Arsenios;Selim, Magdy H
意见声明：尽管在过去的十年里，在医学、神经病学和外科护理方面取得了进步，但脑出血（ICH）的死亡率和发病率仍然很高。从既往ICH治疗试验中吸取的经验教训、对ICH后神经元损伤病理生理学的进一步了解以及成像和院前评估技术的进步，使我们乐观地认为，未来几年可能会出现更有效的ICH治疗方法。治疗ICH的潜在新途径包括增加微创手术技术的使用，使用或不使用溶栓来清除或缩小血肿大小;利用先进的成像技术来改善可能从凝血障碍逆转或止血治疗中获益的患者的选择;超早期诊断和在救护车上开始治疗;以及靶向继发性损伤机制（包括炎症级联反应、血肿周围水肿减轻和血红蛋白降解产物介导的毒性）的新药的用途。
OPINION STATEMENT: The mortality and morbidity from intracerebral hemorrhage (ICH) remain high despite advances in medical, neurologic, and surgical care during the past decade. The lessons learned from previous therapeutic trials in ICH, improved understanding of the pathophysiology of neuronal injury after ICH, and advances in imaging and pre-hospital assessment technologies provide optimism that more effective therapies for ICH are likely to emerge in the coming years. The potential new avenues for the treatment of ICH include a combination of increased utilization of minimally invasive surgical techniques with or without thrombolytic usage to evacuate or reduce the size of the hematoma; utilization of advanced imaging to improve selection of patients who are likely to benefit from reversal of coagulopathy or hemostatic therapy; ultra-early diagnosis and initiation of therapy in the ambulance; and the use of novel drugs to target the secondary injury mechanisms, including the inflammatory cascade, perihematomal edema reduction, and hemoglobin degradation products-mediated toxicity.