早期强化降压在高血压脑出血超急性期中的应用研究  

Applied research of early rapid blood-pressure lowering in hyperacute phase of hypertensive cerebral hemorrhage

作　　者：王静 杨红叶[2] 郝宗佳 焦迎斌[2] Wang Jing;Yang Hongye;Hao Zongjia;Jiao Yingbin(Women's Health Division,Laoshan District Community Service Center,Qingdao,Shandong,266000,China;Department of Neurosurgery,Affiliated Hospital of Qingdao University,Qingdao,Shandong,266000,China)

机构地区：[1]崂山区社区服务中心妇保科,山东青岛26600 [2]青岛大学附属医院神经外科,山东青岛266000

出　　处：《当代医学》2019年第10期8-12,共5页Contemporary Medicine

摘　　要：目的探讨早期强化降压治疗方法对超急性期高血压脑出血血肿扩大的影响。方法回顾分析急诊科就诊的HCH病例32例,根据30 min内动脉收缩血压是否降至140 mmHg以下将32例观察对象分为早期强化降压组和对照组,统计两组脑内血肿是否扩大、是否手术和随访时的mRS评分。结果早期强化降压组中有17.6%(3/17)血肿扩大,对照组中有66.7%(10/15)血肿扩大,两组比较差异有统计学意义(χ~2=7.938,P=0.005)。早期强化降压组中11.8%(2/17)转为手术治疗,对照组中53.3%(8/15)转为手术治疗,两组比较差异有统计学意义(χ~2=6.409,P=0.011)。在随访时,早期强化降压组的平均mRS(2.65±1.057)。对照组平均(3.27±1.280),两组比较差异无统计学意义(t=1.500,P=0.144)。结论在HCH超急性期,早期强化降压可以有效降低血肿扩大和转为手术治疗的风险。与传统降压方式相比,早期强化降压是安全的,并不影响患者的预后。Objective To investigate the effect of early intensive antihypertensive therapy on hematoma enlargement in hyperacute hypertensive cerebral hemorrhage. Methods A retrospective analysis of 32 cases of hypertensive cerebral hemorrhage in the emergency department was conducted. According to whether the arterial systolic blood pressure decreased to below 140 mmHg within 30 min, 32 subjects were divided into early intensive antihypertensive group and control group. Whether the hematoma was enlarged, whether the surgery was performed, and, and mRS scores at follow- up between the two groups were record and statistical analyzed. Results 17.6%(3/17) of the hematoma expanded in the early intensive antihypertensive group and 66.7%(10/15) in the control group. There was a statistically significant difference between the two groups (x^2=7.938,P=0.005). 11.8%(2/17) of the early intensive antihypertensive group was converted to surgery, and 53.3%(8/15) of the control group were converted to surgery. There was a statistical difference between the two groups (x^2=6.409, P=0.011). At follow-up, the mRS of the early intensive antihypertensive group averaged (2.65±1.057). The control group had an average of (3.27±1.280), and there was no significant difference between the two groups (t= 1.500, P=0.144). Conclusion In the hyperacute phase of hypertensive cerebral hemorrhage, early intensive antihypertensive can effectively reduce the risk of hematoma enlargement and conversion to surgical treatment. Compared with the traditional blood pressure reduction method, early strengthening of blood pressure is safe and does not make the prognosis worse.

关 键 词：高血压脑出血 超急性期 早期强化降压 血肿扩大 对照研究 

分 类 号：R743.34[医药卫生—神经病学与精神病学]