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目的:本指南旨在为急性自发性脑出血的诊断和治疗提供最新的综合性推荐意见。方法:通过Medline正式检索截止2006年8月的相关文献,并将撰写委员会已知相关问题的其他论文作为补充,用证据表合并资料。采用美国心脏协会卒中委员会的证据水平分级标准对每项推荐意见进行分级。由5位同行评议专家和卒中委员会领导委员会成员对指南草案进行发表前审阅。预期本指南在3年内完全更新。结果:本文陈述了脑出血的诊断、动脉血压和颅内压增高的处理、脑出血内科并发症的治疗以及复发性脑出血的预防等方面的循证指南。对重组Ⅶ因子延缓早期出血的近期试验进行了讨论。对自发性脑出血治疗的各种外科手术方法提出了推荐意见。最后,对脑出血患者的撤销治疗和临终问题进行了分析。
Purpose: This guide is intended to provide the most current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage. METHODS: Medline was used to formally search for relevant articles as of August 2006 and to supplement other papers in writing about issues known to the committee, and to incorporate the evidence in the form of evidence. Each recommendation was rated using the American Heart Association Stroke Evidence Level grading criteria. Five pre-publication guides were reviewed by five peer reviewers and members of the Stroke Council Leadership Council. This guide is expected to be fully updated within 3 years. RESULTS: This article presents evidence-based guidelines for the diagnosis of cerebral hemorrhage, the management of arterial blood pressure and intracranial pressure, the treatment of medical complications of cerebral hemorrhage and the prevention of recurrent cerebral hemorrhage. Recent trials of recombinant factor VII to delay early bleeding have been discussed. Suggestions for various surgical methods for the treatment of spontaneous intracerebral hemorrhage are given. Finally, the withdrawal treatment and dying of the patients with ICH were analyzed.