Chan Sheila, Hemphill J Claude
Neurocritical Care Program, Department of Neurology, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
Neurocritical Care Program, Department of Neurology, Brain and Spinal Injury Center, San Francisco General Hospital, University of California, San Francisco, Building 1, Room 101, 1001 Potrero Avenue, San Francisco, CA 94110, USA; Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
Crit Care Clin. 2014 Oct;30(4):699-717. doi: 10.1016/j.ccc.2014.06.003. Epub 2014 Jul 30.
Primary, spontaneous intracerebral hemorrhage (ICH) confers significant early mortality and long-term morbidity worldwide. Advances in acute care including investigative, diagnostic, and management strategies are important to improving outcomes for patients with ICH. Physicians caring for patients with ICH should anticipate the need for emergent blood pressure reduction, coagulopathy reversal, cerebral edema management, and surgical interventions including ventriculostomy and hematoma evacuation. This article reviews the pathogenesis and diagnosis of ICH, and details the acute management of spontaneous ICH in the critical care setting according to existing evidence and published guidelines.
原发性自发性脑出血（ICH）在全球范围内导致了显著的早期死亡率和长期致残率。包括检查、诊断和管理策略在内的急性护理进展对于改善ICH患者的预后至关重要。照顾ICH患者的医生应预见到紧急降低血压、逆转凝血功能障碍、管理脑水肿以及包括脑室造口术和血肿清除术在内的手术干预的必要性。本文回顾了ICH的发病机制和诊断，并根据现有证据和已发表的指南详细介绍了在重症监护环境中自发性ICH的急性管理。
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