超早期强化降压对高血压脑出血患者预后的影响  

Effect of Ultra-early Intensive Blood Pressure Reduction the Prognosis of Patients with Hypertensive Cerebral Hemorrhage

作　　者：刘国庆 张小乔[1] LIU Guo-qing;ZHANG Xiao-qiao(Department of General Medicine,Taihe Hospital,Hubei Universi-ty of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属太和医院综合医疗科,湖北十堰442000

出　　处：《湖北医药学院学报》2022年第4期387-391,共5页Journal of Hubei University of Medicine

基　　金：湖北医药学院附属太和医院院级重点项目资助(2021JJXM056)。

摘　　要：目的:研究超早期控制血压对患者再出血、神经功能及远期预后的影响。方法:回顾我院神经外科2018年8月至2019年12月收治的70例脑出血患者的临床资料,根据治疗方案的不同分为强化降压组和常规治疗组,强化降压组入院2 h血压目标值120~140 mmHg,常规治疗组入院2 h血压目标值140~180 mmHg,对比两组血肿变化,二次出血率,NIHSS评分和ADL评分。结果:强化降压组与常规治疗组在治疗72 h内血肿量稍增加,但两组比较差异无统计学意义(P>0.05);强化降压组再出血率为5.71%,常规治疗组再出血率为14.28%,强化降压组高于常规治疗组,但两组比较差异无统计学意义(P>0.05);治疗24 h,两组患者NIHSS评分差异无统计学意义(P>0.05);治疗14 d,两组患者的NIHSS评分较入院时均有不同程度下降,而强化降压组NIHSS评分明显低于常规治疗组,差异有统计学意义(P<0.05);强化降压组神经功能及预后均优于常规治疗组(P<0.05),差异有统计学意义。结论:早期强化降压治疗有助于降低急性脑出血患者再出血率,使患者神经功能得到明显改善,显著提高远期生活能力。Objective To study the effect of ultra-early control of blood pressure on rebleeding, neurological function and long-term prognosis. Methods The clinical data of 70 patients with cerebral hemorrhage treated in the department of neurosurgery of our hospital from August 2018 to December 2019 were reviewed. According to the different treatment schemes, the patients were divided into intensive antihypertensive group and routine treatment group. The target values of blood pressure at 2 hours after admission in intensive antihypertensive group was 120~140 mmHg, and the 2-hour blood pressure target value in the conventional treatment group was 140~180 mmHg. The changes of hematoma, secondary bleeding rate, NIHSS score and ADL score were compared between the two groups. Results The amount of hematoma increased slightly within 72 hours in intensive antihypertensive group and routine treatment group, but there was no significant difference between the two groups(P>0.05). The rebleeding rate of intensive antihypertensive group was 5.71%, and that of routine treatment group was 14.28%. The rebleeding rate of intensive antihypertensive group was higher than that of routine treatment group, but there was no significant difference between the two groups(P>0.05). After 24 hours treatment, there was no significant difference in NIHSS score between the two groups(P>0.05). On the 14 th day of treatment, the NIHSS score of the two groups decreased in varying degrees compared with that at admission, while the NIHSS score of the intensive antihypertensive group was significantly lower than that of the routine treatment group. The neurological function and prognosis of intensive antihypertensive group were better than those of routine treatment group(P<0.05), and the difference was statistically significant. Conclusion Early intensive antihypertensive therapy is helpful to reduce the rebleeding rate of patients with acute cerebral hemorrhage, improve their neurological function and improve their long-term living ability.

关 键 词：早期降压 脑出血 再出血 神经功能 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]