早期强化降压对高血压脑出血立体定向微创术后疗效的影响  

Effect of early intensive hypotension on stereotactic minimally invasive surgery after hypertensive intracerebral hemorrhage

作　　者：曾琼 黎景光[1] 李邱旺 龙任 ZENG Qiong;LI Jingguang;LI Qiuwang;LONG Ren(Department of Neurosurgery,Loudi Central Hospital,Loudi 417000,China)

机构地区：[1]娄底市中心医院神经外科

出　　处：《中国实用神经疾病杂志》2019年第15期1694-1699,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨早期强化降压对高血压脑出血立体定向微创术后疗效的影响。方法163例高血压脑出血患者,立体定位微创手术后随机分为早期强化降压组(120 mmHg≤收缩压≤140 mmHg)81例和指南降压组(收缩压≤180 mmHg)82例,比较2组治疗后的血肿体积、神经功能美国国立卫生研究院卒中量表(NIHSS)评分、并发症发生率及病死率等变化。结果早期强化降压组3 d、7 d血肿体积、7 d、14 d的NIHSS评分明显低于指南降压组,比较差异有统计学意义(P<0.05);早期强化降压组14 d血肿体积、3 d NIHSS评分及并发症发生率、病死率差异并无统计学意义(P>0.05)。结论早期强化降压对高血压脑出血立体定向微创术后治疗确有疗效,可更好控制血肿,改善患者临床症状,不增加并发症及病死率风险。Object To investigate the effect of early intensive antihypertensive therapy on stereotactic minimally invasive surgery.Methods After stereotactic minimally invasive surgery,163 patients with hypertensive intracerebral hemorrhage were randomly divided into the early intensive antihypertensive group(systolic blood pressure 120-140mmHg)in 81 cases and the guide hypotensive group(systolic blood pressure≤180mmHg)in 82 cases.Hematoma volume,neurological function,National Institutes of Health Stroke Scale(NIHSS)score,complication rate,and mortality were compaered.Results The mean hematoma volume at 3-day,7-day and the mean scores of NIHSS at 7-day,14-day after treatment in early intensive antihypertensive group and guideline antihypertensive group were statistically significant difference(P<0.05).The mean hematoma volume at 14-day,the mean scores of NIHSS at 3-day and the incidence of morbidity and mortality were no difference.Conclusion The early intensive antihypertensive treatment for hypertensive intracerebral hemorrhage after minimally invasive stereotactic operation has good efficacy,can reduce the hematoma enlargement,improve clinical symptoms,but not increases the incidence of morbidity and mortality.

关 键 词：早期强化降压 高血压脑出血 立体定向微创手术 血肿体积 神经功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]