脑内出血:目前急性治疗方法
Charlotte Cordonnier1, Andrew Demchuk2, Wendy Ziai3
1University of Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, Centre Hospitalier Universitaire Lille, Department of Neurology, Lille, France.
Lancet (London, England)
|October 16, 2018
概括
急性自发性脑内出血需要积极的治疗以获得更好的结果. 早期血压控制和专家护理可以改善这种危及生命的大脑出血的生存和恢复.
科学领域:
- 神经学
- 神经外科
- 危急护理医学
背景情况:
- 急性自发性脑内出血 (ICH) 是一个严重的全球健康问题,死亡率高,治疗选择有限.
- ICH是一种复杂的疾病,临床和成像发现有助于确定病因,预后和治疗策略.
- 患者的结局受血瘤特征 (部位,质量效应,内压力) 和脑和神经炎症等二次并发症的影响.
研究的目的:
- 审查影响急性自发脑内出血患者生存和康复的关键因素.
- 概述基于证据的管理策略,以改善ICH的结果.
- 强调协调,多学科的ICH护理的重要性.
主要方法:
- 关于脑内出血治疗的当前文献和临床证据的审查.
- 影响预后的因素分析,包括血瘤特性和二次脑损伤.
- 评估各种治疗干预和管理目标的有效性.
主要成果:
- 生存和功能恢复与血液瘤的位置,质量效应和内压力显著相关.
- 大脑,周 hematomal 神经毒性和炎症有助于糟糕的结果.
- 中等水平的证据支持积极管理,包括专门的中风治疗,神经密集型干预,血压控制和凝血校正.
结论:
- 积极的治疗策略,包括避免早期的息治疗,为ICH患者提供了有益的效果.
- 协调专家护理,神经密集监测和及时的手术干预至关重要.
- 早期的血压管理和凝血病的逆转对于改善自发性脑内出血的预后至关重要.
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