Grillo P, Velly L, Bruder N
Département d'Anesthésie-Réanimation, CHU de La Timone-Adultes, 264, rue Saint-Pierre, 13385 Marseille, France.
Ann Fr Anesth Reanim. 2006 Aug;25(8):868-73. doi: 10.1016/j.annfar.2006.03.030. Epub 2006 May 15.
Haemorrhagic stroke is frequent and associated with a high mortality and morbidity. Less than 30% of patients are still alive five years after onset and few patients regain functional independence. The worsening effect of anticoagulation has been demonstrated and the failure to rapidly normalize coagulation further increases haematoma expansion. In a recent phase II trial, recombinant activated factor VII given within 4 hours of stroke onset, reduced haematoma growth, mortality and disability. An aggressive blood pressure and intracranial pressure control early after the haemorrhage seems beneficial. A large prospective randomized study (the STICH trial) did not demonstrate any beneficial effect of surgery.
出血性中风很常见，且与高死亡率和高发病率相关。发病五年后仍存活的患者不到30%，很少有患者恢复功能独立。抗凝的恶化作用已得到证实，未能迅速使凝血正常化会进一步增加血肿扩大。在最近的一项II期试验中，在中风发作后4小时内给予重组活化因子VII，可减少血肿生长、死亡率和残疾率。出血后早期积极控制血压和颅内压似乎有益。一项大型前瞻性随机研究（STICH试验）未显示手术有任何有益效果。
