Liu-DeRyke Xi, Rhoney Denise
Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA.
Pharmacotherapy. 2008 Apr;28(4):485-95. doi: 10.1592/phco.28.4.485.
Intracranial hemorrhage results in poor neurologic outcomes and high mortality. Current management is limited to supportive care. In addition to the initial bleeding event, rebleeding and hematoma expansion have been identified as major risk factors for poor outcomes in these patients. The antifibrinolytic agents tranexamic acid, aminocaproic acid, and recombinant activated factor VII (rFVIIa) have been studied with the hopes of achieving early hemostasis and improving outcomes. Available data suggest that tranexamic acid and aminocaproic acid are more harmful than beneficial for this indication; therefore, they have no role in the treatment of intracranial bleeding. Alternatively, rFVIIa, has shown promising results in the management of spontaneous intracerebral hemorrhage. Clinicians should be aware of the available evidence regarding the use of these hemostatic agents in the management of intracranial hemorrhage, including traumatic brain injury, intracerebral hemorrhage, and subarachnoid hemorrhage.
颅内出血会导致不良的神经学预后和高死亡率。目前的治疗仅限于支持性护理。除了初始出血事件外，再出血和血肿扩大已被确定为这些患者预后不良的主要危险因素。抗纤维蛋白溶解剂氨甲环酸、氨基己酸和重组活化因子VII（rFVIIa）已被研究，以期实现早期止血并改善预后。现有数据表明，氨甲环酸和氨基己酸对此适应症弊大于利；因此，它们在颅内出血的治疗中没有作用。相比之下，rFVIIa在自发性脑出血的治疗中已显示出有前景的结果。临床医生应了解有关这些止血剂在颅内出血（包括创伤性脑损伤、脑出血和蛛网膜下腔出血）治疗中使用的现有证据。
