早期强化降压对高血压脑出血血肿扩大的治疗作用

Influence of early intensively antihypertensive treatment on hematoma enlargement in patients with hypertensive intra-cerebral hemorrhage

目的分析早期强化降压治疗对高血压脑出血患者血肿扩大的影响。方法选择本院2007-10—2012-10急诊入院的高血压脑出血患者160例,按降压方式不同随机分为早期强化降压组(80例)和指南标准降压组(80例),分别给予强化降压和标准降压治疗。观察2组患者入院时及治疗24h后2次头颅CT血肿体积变化情况。结果早期强化降压组发病0～24h平均收缩压控制在145mmHg,24h内血肿体积扩大6例(7.5%);指南标准降压组平均收缩压控制在170mmHg,24h内血肿体积扩大14例(17.5%),2组血肿扩大发生率比较,早期强化降压组明显小于指南标准降压组,差异有统计学意义(P<0.05)。结论高血压脑出血早期强化降压治疗可预防和减少血肿扩大,降低病死率和致残率,改善预后。

Objective To analyze the influence of early intensively antihypertensive therapy on hematoma enlargement in patients with hypertensive intra-cerebral hemorrhage （HICH）. Methods One hundred and sixty emergency patients with HICH, who were admitted into this department during October 2007 to October 2012, according to the different ways of de- compression, were randomly divided into two groups, early intensively antihypertensive group （80 cases） and standard guide- line antihypertensive group（80 cases）, was respectively given intensively antihypertensive therapy and standard guideline anti- hypertensive therapy. The efficacy was evaluated by hematoma volume 24 hours after treatment. Results Early intensively an- tihypertensive group and standard guideline antihypertensive group the 0~24-hour mean systolic blood pressure control respec- tively for 145 mmHg and 170 mmHg, 24-hour hematoma volume enlargement respectively in 6 cases （7.5%） and 14 cases （ 17.5 5 ） ; two groups of hematoma enlargement in comparison, there was a statistical difference between the two groups （P（ 0.05）. Conclusion Early intensively antihypertensive therapy can prevent and reduce hematoma enlargement, and reduce the mortality and morbidity and improve the prognosis in HICH patients.