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脑出血是神经科常见急症之一,其超早期的手术治疗和止血治疗是目前临床研究的两大热点。常用的手术方法有立体定向术、钻孔及(或)辅以血肿碎吸(包括内镜)或溶解引流术、开颅血肿清除术及脑室引流血肿溶解术。超早期应用的止血剂选择主要有6-氨基己酸、止血芳酸、抑肽酶以及重组活化因子Ⅶ,凝血因子有可能成为真正意义上的有效治疗脑出血的药物。本文就各种常用手术方法的特点、手术时机、存在问题和超早期止血治疗中的止血药选择、止血加以综述。
Intracerebral hemorrhage is one of the common neurological emergency, and its ultra-early surgical treatment and hemostasis are two hot topics in clinical research. Commonly used surgical methods are stereotactic surgery, drilling and (or) assisted by hematoma suction (including endoscopic) or dissolution and drainage, craniotomy and ventricular drainage hematoma lysis. Ultra-early application of the main choice of hemostatic 6-aminocaproic acid, hemostatic aromatase, aprotinin and recombinant activator VII, coagulation factors may become a real sense of the effective treatment of cerebral hemorrhage drugs. This article reviews the characteristics of various commonly used surgical procedures, timing of surgery, problems and the choice of hemostatic agents in ultra-early hemostasis.