Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
World Neurosurg. 2013 Feb;79(2):307-12. doi: 10.1016/j.wneu.2012.06.023. Epub 2012 Jun 19.
To summarize the current knowledge of the mechanisms leading to rebleeding and the prevention of rebleeding after subarachnoid hemorrhage (SAH).
A literature search was performed to investigate factors associated with rebleeding after SAH.
The review of the literature revealed that rebleeding is a complex and multifactorial event involving hemostasis, pathophysiologic, and anatomic factors. Administration of antifibrinolytics has been shown to have a dramatic effect on the rebleeding rate, so changes in coagulation and fibrinolysis must be involved in rebleeding.
Further studies are warranted before the exact mechanisms leading to rebleeding are established and the optimal preventive measures are made available. At the present time, antifibrinolytic therapy remains the only realistic protective measure during the initial 6 hours after SAH during which the rebleeding rate is highest.
总结导致蛛网膜下腔出血（SAH）后再出血的机制以及再出血预防的相关知识。
进行文献检索，以研究与 SAH 后再出血相关的因素。
文献回顾表明，再出血是一个复杂的多因素事件，涉及止血、病理生理和解剖因素。抗纤维蛋白溶解剂的应用已显示对再出血率有显著影响，因此再出血必然涉及凝血和纤维蛋白溶解的变化。
在明确导致再出血的确切机制并提供最佳预防措施之前，还需要进一步的研究。目前，抗纤维蛋白溶解治疗仍然是在再出血率最高的 SAH 后最初 6 小时内唯一可行的保护措施。
