脑出血急性期高血压的处理与预后的关系

Relationship between treatment of hypertension and prognosis in patients with intracerebral hemorrhage at acute stage

目的 分析脑出血急性期高血压的不同处理与预后的关系,以提高脑出血的生存率。方法 回顾性分析了118例急性脑出血患者并且发病第一天血压均≥24/133kPa,分为3组,组1:54例单纯用降颅压药物治疗。组2:54例降颅压药同时服用口服降压药。组3:10例降颅压药同时用静脉降压药。对3组患者第1、7、14天的血压加以比较,并对其预后进行比较。结果 三组收缩压及舒张压在第1、7、14天比较(P均>005)没有显著性差异。发病第7天血压降至正常者84例,占71%。发病第14天血压降至正常者104例,占8814%。组3比组2、组1预后差。结论 急性脑出血早期血压升高,是一种代偿性反应颅压降低后血压有所下降。发病7～14天,血压趋向正常。因此急性脑出血后应首先降颅压,对于静脉降压药在脑出血急性期应慎用。

Objective To study and investigate the treatment of hypertension in patients with intracerebral hemorrhage at acute stage for increasing the survival rate.Methods 118 cases of acute intracerebral hemorrhage patients were chosen on the first day with arterial blood pressure≥24/13.3 kPa.They were divided into three groups.In Group One with 54 cases,decreasing intracranial pressure drugs were used.In Group Two with 54 cases ,drugs of decreasing intracranial pressure and decreasing blood pressure (taken orally) were used simultaneously.In Group Three with 10 cases,drugs of decreasing intracranial pressure and intravenous drugs of decreasing blood pressure were used simultaneously.The 1st day's,7th day's and 14th day's blood pressures of the patients' in the three groups and their prognosis were compared with each other.Results There was no significant difference on the 1st day's,7th day's and 14th day's systolic and diastolic pressures among the three groups.On the 7th day,there were 84 cases (71%)that the patients' blood pressures returned to normal.On the 14th day,there were 104 cases (88%)that the patients' blood pressures returned to normal.The prognosis of Group Three is not so good as that of Group One and Group Two.Conclusion Blood pressure increasing at acute stage of intracerebral hemorrhage is a compensatory reflection.Following the decreasing of the intracranial pressure,the blood pressure also decrease somewhat.From the 7th day to 14th day,most of the patients' blood pressures retured to normal.Therefore,the first chosen treatment for the intracerebral hemorrhage at acute stage is to decrease intracranial pressure.At acute stage,intravenous drugs for decreasing blood pressure must be given carefully. [