早期强化降压在基底节区脑出血中的应用价值分析

Analysis on application value of early intensive antihypertensive treatment of intracerebral hemorrhage in basal ganglia

目的探讨早期强化降压在基底节区脑出血中的应用价值。方法回顾性分析医院收治的110例基底节区脑出血患者的临床资料,按降压方式不同分为强化组(n=62)与常规组(n=48),强化组入院1 h内给予硝酸甘油强化降压,控制收缩压为130~140 mm Hg;常规组进行常规降压处理,维持收缩压<180 mm Hg,比较两组治疗前后血肿量、神经功能量表(NIHSS)、日常生活能力量表(ADL)中Barthel指数及改良Rankin量表(mRS)评分的变化。结果 (1)治疗1和24 h时,两组收缩压均降低(P<0.05),且强化组降低幅度大于常规组(P<0.05);(2)治疗24 h和治疗5 d时,两组血肿量均有上升,但强化组的血肿量低于常规组(P<0.05);(3)治疗5 d和出院90 d时,两组神经功能评分均降低(P<0.05),且强化组评分降低幅度大于常规组(P<0.05);(4)出院90 d时,强化组Barthel指数评分高于常规组,mRS表评分低于常规组(P<0.05)。结论采用早期强化降压方案治疗基底节区脑出血,可减少患者血肿体积,提高其神经功能和日常生活能力,改善其预后。

Objec t ive To explore the application value of early intensive antihypertensive treatment of intracerebral hemorrhage in the basal ganglia. MeAods A retrospective analysis was conducted on clinical data of 110 patients with intracerebral hemorrhage in the basal ganglia admitted to our hospital. The patients were divided into an intensive group （n =62） and a routine group （n =48） according to the antihypertensive method performed on them; the intensive group ＂was given nitroglycerin one hour after the admission for intensive antihypertensive treatment, and the systolic pressure was controlled within 130-140 mmHg; the routine group was given routine antihypertensive treatment, and the systolic pressure was maintained 〈180 mmHg; the changes in the hematoma volume and the scores of National Institutes of Health Stroke Scale （NIHSS）, the Barthel index of the Activity of Daily Living Scale （ADL） and the modified Rankin Scale were compared between the two groups before and after the treatment. Results （1）One hour and 24 hours after the treatment, the systolic pressure reduced in both groups （P 〈 0.05） and the reduction in the intensive group was more significant than that in the routine group （P〈 0.05）; （2）24 hours and five days after the treatment, the hematoma volume increased in both groups, but the hematoma volume in the intensive group was lower than that in the routine group （P 〈 0.05）; （3）Five days after the treatment and 90 days after the discharge, the NIHSS scores reduced in both groups（P 〈 0.05） and the reduction in the intensive group was more significant than that in the routine group （P 〈 0.05）; （4 ）9 0 days after discharge, the score of Barthel index in theintensive group was higher than that in the routine group, but the score of mRS scale in the routine group was higher （P 〈 0.05）. Conclusion The application of early intensive antihypertensive treatment protocol for the intracerebral hemorrhage in the basal ganglia can reduce the hematoma volume of patients and improve their neurological function, activity of daily living and the prognosis.