脑出血超急性期强化降压治疗的安全性与有效性

The Safety and Effectiveness of Intensive Antihypertensive Therapy in Hyperacute Stage of Cerebral Hemorrhage

目的:分析脑出血超急性期强化降压治疗的安全性与有效性。方法:本院收治的脑出血超急性期患者共60例入组,随机分组,强化降压组在患者起病3 h内应用乌拉地尔注射液(商品名为亚宁定)静脉滴注进行降压治疗,血压目标值为收缩压140 mm Hg;指南组血压维持在180 mm Hg左右。发病24 h后复查头颅CT平扫,观察血肿扩大程度(血肿扩大定义为血肿体积增加>33%或>12.5 ml)。病程中记录有无出血发生。观察患者发病后第90天mRS评分及NIHSS评分,应用统计学方法评价超急期强化降压治疗的安全性及有效性。结果:强化降压组血肿扩大比例、治疗后患者mRS评分及NIHSS评分均优于指南组(P<0.05)。随访9个月,强化降压组再出血率0,低于指南组的再出血20.00%,且致残率6.67%,低于指南组的33.33%,差异均有统计学意义(P<0.05)。结论:脑出血超急性期强化降压治疗的安全性与有效性高。

Objective:To analyze the safety and effectiveness of intensive antihypertensive therapy in the hyperacute stage of cerebral hemorrhage.Method:A total of 60 patients with super acute stage of cerebral hemorrhage who admitted to our hospital were randomly divided into groups.The intensive antihypertensive group was given intravenous infusion of Urapidil Injection(trade name Yaningding)within 3 hours of onset in the antihypertensive treatment,the target value of blood pressure was 140 mm Hg;the blood pressure in the guide group was maintained at about 180 mm Hg.The CT scan of the head 24 hours after the onset was rechecked,and the degree of hematoma expansion(hematoma expansion was defined as an increase in hematoma volume>33%or>12.5 ml)was observed.During the course of the disease,the adverse reactions were recorded.The mRS score and NIHSS score on the 90th day after the onset of the patient were observed,and statistical methods were used to evaluate the safety and effectiveness of intensive antihypertensive therapy in the super emergency period.Result:The enlargement rate of hematoma,mRS score and NIHSS score after treatment in the intensive hypotension group were better than those in the finger group(P<0.05).During the 9-month follow-up,the rebleeding rate in the intensive hypotension group was 0,which was lower than 20.00%in the finger group,and the disability rate was 6.67%,which was lower than 33.33%in the guide group,and the difference was statistically significant(P<0.05).Conclusion:intensive antihypertensive therapy for hyperacute cerebral hemorrhage is safe and effective.