Li Zhifang, You Mingfeng, Long Chunnan, Bi Rentang, Xu Haoqiang, He Quanwei, Hu Bo
Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Neurol. 2020 Jul 17;11:702. doi: 10.3389/fneur.2020.00702. eCollection 2020.
Intracerebral hemorrhage (ICH) is the most lethal type of stroke, but there is no specific treatment. After years of effort, neurologists have found that hematoma expansion (HE) is a vital predictor of poor prognosis in ICH patients, with a not uncommon incidence ranging widely from 13 to 38%. Herein, the progress of studies on HE after ICH in recent years is updated, and the topics of definition, prevalence, risk factors, prediction score models, mechanisms, treatment, and prospects of HE are covered in this review. The risk factors and prediction score models, including clinical, imaging, and laboratory characteristics, are elaborated in detail, but limited by sensitivity, specificity, and inconvenience to clinical practice. The management of HE is also discussed from bench work to bed practice. However, the upmost problem at present is that there is no treatment for HE proven to definitely improve clinical outcomes. Further studies are needed to identify more accurate predictors and effective treatment to reduce HE.
脑出血（ICH）是最致命的中风类型，但目前尚无特效治疗方法。经过多年努力，神经科医生发现血肿扩大（HE）是脑出血患者预后不良的重要预测指标，其发生率并不罕见，范围在13%至38%之间。本文更新了近年来脑出血后血肿扩大的研究进展，综述涵盖了血肿扩大的定义、患病率、危险因素、预测评分模型、机制、治疗及前景等主题。详细阐述了包括临床、影像和实验室特征在内的危险因素及预测评分模型，但受敏感性、特异性及临床应用不便等因素限制。还从基础研究到临床实践探讨了血肿扩大的管理。然而，目前最主要的问题是尚无经证实能明确改善临床结局的血肿扩大治疗方法。需要进一步研究以确定更准确的预测指标和有效的治疗方法来减少血肿扩大。
