超急性期强化降压对基底节区脑出血患者的治疗效果

Therapeutic Effect of Hyperacute Intensive Antihypertensive Treatment on Patients with Basal Ganglia Cerebral Hemorrhage

目的:观察超急性期强化降压对基底节区脑出血患者的治疗效果。方法:基底节区脑出血70例随机分为对照组和强化组,各35例。对照组使用普通降压的策略,强化组采用强化降压策略。于治疗前及治疗后24 h行CT检测计算血肿体积及治疗24 h内发生血肿扩大的比例;于治疗前,治疗后24 h及14 d采用格拉斯哥昏迷量表(GCS)评分及美国国立卫生研究院卒中量表(NIHSS)评估患者意识情况和神经功能;于治疗前,治疗后14 d采用Barthel指数(BI)评估患者日常生活活动能力;记录2组入院30 d内的死亡情况。结果:治疗后24 h,2组血肿体积都呈上升趋势,但强化组的血肿体积小于对照组(P<0.05);强化组发生血肿扩大患者的比例低于对照组(P<0.05);2组GCS评分、NIHSS评分差异无统计学意义(均P>0.05)。治疗后14 d,强化组的GCS评分和BI评分高于对照组,NIHSS评分低于对照组(均P<0.05)。2组死亡率差异无统计学意义(P>0.05)。结论:处于超急性期内的少量基底节区出血患者,采用强化降压疗法,可能有助于提升疗效、降低血肿扩大程度、保护神经功能。

Objective:To observe the effect of intensive hypotension during the hyperacute phase on patients with cerebral hemorrhage in the basal ganglia.Methods:A total of 70 patients with basal ganglia hemorrhage were randomly divided into the control group or enhanced group,with 35 in each.Treatment in the control group utilized an ordinary antihypertensive strategy,while that in the enhanced group used an enhanced antihypertensive strategy.CT scans were performed to measure hematoma volume before treatment and 24 hours after treatment,and the incidence of hematoma enlargement within 24 hours of treatment was calculated.The Glasgow Coma Scale(GCS)score and National Institutes of Health Stroke Scale(NIHSS)score were obtained before,24 hours after,and 14 days after treatment to assess consciousness and neurological function.The Barthel Index(BI)was used to evaluate ability in activities of daily life before and 14 days after treatment.Patient deaths within 30 days of hospitalization were recorded.Results:In both groups,hematoma volume showed an increase 24 hours after treatment,but the enhanced group showed a smaller volume than the control group(P<0.05).The enhanced group yielded a smaller proportion of patients with hematoma enlargement compared to the control group(P<0.05).There was no significant difference in GCS and NIHSS scores between the two groups(both P>0.05).Fourteen days after treatment,the enhanced group showed higher GCS and BI scores and a lower NIHSS score compared to the control group(all P<0.05).There was no significant difference in mortality between the 2 groups(P>0.05).Conclusion:For patients during the hyperacute period of mild basal ganglia hemorrhage,the use of intensive antihypertensive treatment can strengthen treatment effectiveness,limit hematoma enlargement,and protect nerve function.