高血压脑出血急性期血压与血肿扩大的关系

Study of the Correlations between Changs in Blood Pressure and Hematoma Expansion(HE) after Hypertensive Intracerebral Hemorrhage(ICH) Patients Admission

目的探讨高血压脑出血急性期血压与血肿扩大的关系。方法符合纳入标准的2006年1月～2009年6月江门市中心医院神经内科高血压脑出血患者,在入院时和24h后进行颅脑CT扫描,计算不同时间的血肿体积,同时进行24h动态血压监测,将平均收缩压≥150mmHg和<150mmHg的病例分成两组分别进行资料整理和统计比较。结果所有226例病例中在入院后24h内血肿扩大的有58例,占25.66%,平均收缩压≥150mmHg的病例共有168例,其中血肿扩大的有51例,占30.4%,扩大体积(14.8±1.0)mL。平均收缩压小于150mmHg的病例共有58例,其中血肿扩大的有7例,占12.1%,扩大体积(13.9±1.3)mL。两组血肿扩大率比较有显著性差异。两组血肿扩大的体积比较,差异无显著性。结论高血压脑出血急性期血压升高与血肿扩大密切相关,年龄与血肿扩大的体积相关,降低血压可能有助于控制血肿继续扩大。

Objective To study the correlations between changs in blood pressure（BP） and HE after admission. Methods 226 patients with hypertensive ICH underwent computed tomography（CT） at the admission and 24 hours after admission. Series of systolic blood pressure（SBP） were recorded from admission to the time of the second CT scan. Patients was distributed to two groups according to Mean SBP（ t〉 150mmHg, 〈 150mmHg）. Results Among 168 patients with SBP≥ 150mmHg,51 patients show HE,the enlargement volume of those patients is （14.8 ±1.0）mL.Among 58 patients with SBP〈 150mmHg, 7 patients occurred HE, the enlargement volume of those patients is（ 13.9 ±1.3 ）mL. The HE volume of those patients is （13.9 ±1.3）mL. Compared with patients of SBP〈150mmHg,Patients of SBP≥150mmHg displayed the higher occure ratio of HE, but comprison of the emLargement volume between the two groups has not significantly statistical difference. Conclusion Elevated BP in hypertensive ICH increases the risk of HE. Enlargement of hematoma volume is age-related.To lower BP may help to control the hematoma continues to expand.