脑出血患者病死率与血压相关性的研究  

Research on the Correlation between Mortality of Intracerebral Hemorrhage Patients and Their Blood Pressure

作　　者：高林[1] 孙志红[1] 李欣舒 李胜华[1] 

机构地区：[1]沧州市吴桥县人民医院,河北沧州061800

出　　处：《华西医学》2013年第3期331-333,共3页West China Medical Journal

摘　　要：目的探讨脑出血患者病死率与发病早期不同血压水平的关系。方法选择2006年2月-2012年6月在我院住院、符合入选标准及排除标准的患者120例,经头颅CT证实为基底节区脑出血,血肿体积20～40 mL,收缩压<200 mm Hg(1 mm Hg=0.133 kPa),舒张压<110 mm Hg。按照中国高血压分级标准(1级高血压:收缩压140～159 mm Hg或舒张压90～99 mm Hg;2级高血压:收缩压160～179 mm Hg或舒张压100～109 mmHg;3级高血压:收缩压≥180 mm Hg或舒张压≥110 mm Hg)将患者分组,各组采用降颅内压、营养神经、维持水电解质平衡、对症治疗及康复治疗和康复护理等常规治疗,观察2周内各组病死率。结果 1级高血压组与2级高血压组2周内病死率比较,差异无统计学意义(χ2=0.075,P=0.785);1级高血压组与3级高血压组2周内病死率比较,差异有统计学意义(χ2=5.698,P=0.017);2级高血压组与3级高血压组2周内病死率比较,差异有统计学意义(χ2=4.528,P=0.033)。结论对于早期血压较高的脑出血患者,进行积极的降压治疗,将血压控制在2级高血压水平,可以明显降低病死率。Objective To explore the relationship between the early elevated blood pressure and mortality in patients with intracerebral hemorrhage.Methods A total of 120 patients treated in our hospital between February 2006 and June 2012 met the inclusion and exclusion criteria.They were confirmed by cranial computer tomography for basal ganglia intracerebral hemorrhage.Their hematoma volume was between 20 to 40 mL;systolic blood pressure was below 200 mm Hg（1 mm Hg=0.133 kPa）;diastolic pressure was below 110 mm Hg.According to the Chinese hypertension grading standard（grade 1 hypertension： systolic blood pressure 140-159 mm Hg,or diastolic blood pressure 90-99 mm Hg;grade 2 hypertension： systolic blood pressure 160-179 mm Hg,or diastolic blood pressure 100-109 mm Hg;grade 3 hypertension： systolic blood pressure higher than 180 mm Hg,or diastolic blood pressure higher than 110 mm Hg）,the patients were divided into three groups.All patients were treated by reducing intracranial pressure,nerve nutrition,maintaining water and electrolyte balance,symptomatic treatment and rehabilitation treatment,rehabilitation nursing and other conventional treatment.We observed mortality rate of each group within two weeks.Results Mortality rate within two weeks between grade 1 hypertension group and grade 2 hypertension group（χ2=0.075,P=0.785） had no significant difference;Mortality rate within two weeks between grade 1 hypertension group and grade 3 hypertension group（χ2=5.698,P=0.017） had a significant difference;Mortality rate within two weeks between grade 2 hypertension group and grade 3 hypertension group（χ2=4.528,P=0.033） also had a statistically significant difference.Conclusion For patients with high blood pressure and early cerebral hemorrhage,controlling blood pressure to be within grade 2 hypertension level through antihypertensive therapy can significantly reduce the mortality.

关 键 词：脑出血 病死率 血压水平 

分 类 号：R743.34[医药卫生—神经病学与精神病学]