急性脑梗死再灌注治疗后颅内出血分型的研究进展

Research Progress on the Type of Intracranial Hemorrhage after Reperfusion Therapy for Acute Ischemic Stroke

摘要: 再灌注损伤是急性缺血性脑卒中患者接受静脉溶栓后常见的并发症，表现为颅内出血或脑水肿。本文综述了再灌注损伤后颅内出血的发生机制、危险因素、预后影响因素、临床和影像学表现以及预防和治疗措施。再灌注损伤后颅内出血可表现为脑实质出血、蛛网膜下腔出血和脑室出血。影像学检查可提示出血的部位和严重程度。目前针对再灌注损伤后出血的预防和治疗方法主要包括：严格筛选溶栓适应证，控制溶栓后血压，辅以神经保护剂等药物治疗。总体而言，再灌注损伤后出血的危害严重，需要引起临床医师的高度重视并采取相应的预防和治疗措施。

Abstract: Reperfusion injury is a common complication of acute ischemic stroke patients after intravenous thrombolysis, manifested as intracranial hemorrhage or cerebral edema. This article reviews the mechanism, risk factors, prognostic influencing factors, clinical and imaging manifestations, and prevention and treatment measures of intracranial hemorrhage after reperfusion injury. Intracranial hemorrhage after reperfusion injury can be manifested as cerebral parenchymal hemorrhage, subarachnoid hemorrhage and ventricular hemorrhage. Imaging examination can indicate the location and severity of the bleeding. At present, the prevention and treatment methods for bleeding after reperfusion injury mainly include: strict screening of thrombolytic indications, control of post thrombolytic blood pressure, supplemented by neuroprotective agents and other drug treatment. Generally speaking, the harm of bleeding after reperfusion injury is serious, which requires clinicians to pay great attention and take corresponding prevention and treatment measures.