Schisano G
Surg Neurol. 1978 Oct;10(4):217-22.
Antifibrinolytic drugs have been investigated in a series of 58 patients with recent aneurysmal subarachnoid hemorrhage. It is concluded that tranexamic acid (AMCA) provides a rational method for reducing the frequency of recurrences, and that antifibrinolytic treatment is a preliminary to surgical intervention. In the present series, ischemic complications, which often follow aneurysmal hemmorrhage, seem to be of a more serious nature. There is evidence also that hydrocephalus due to adhesive arachnoiditis is a rare occurrence. The last 20 patients of the present series have been treated with very low doses of AMCA associated with parotid kallikrein inhibitor (Trasylol); this dosage has been effective in preventing recurrence and has appeared to be freer from severe side effects.
对58例近期发生动脉瘤性蛛网膜下腔出血的患者使用抗纤溶药物进行了研究。得出的结论是,氨甲环酸(AMCA)为降低复发频率提供了一种合理的方法,且抗纤溶治疗是手术干预的前奏。在本系列研究中,动脉瘤性出血后常出现的缺血性并发症似乎更为严重。也有证据表明,粘连性蛛网膜炎所致脑积水很少见。本系列研究的最后20例患者采用了与腮腺激肽释放酶抑制剂(抑肽酶)联合使用的极低剂量AMCA进行治疗;该剂量在预防复发方面有效,且似乎较少出现严重副作用。