浅析高血压对脑出血患者早期脑血肿扩大的影响

The effects of hypertension on the enlargement of early-stage hematoma and ways to prevention

目的:探讨高血压对脑出血患者早期脑血肿扩大的影响。方法:选取某医院2011年6月至2014年6月期间收治的193例脑出血患者作为研究对象。根据患者的病情将这些患者分为脑血肿扩大组和非脑血肿扩大组,脑血肿扩大组中有31例患者,非脑血肿扩大组中有162例患者。询问所有患者的病史、年龄,测量其血压,对其进行凝血功能检查、颅脑CT检查。然后分析并比较两组患者发病初期的血压值、年龄、高血压病史、脑血肿发生的部位、GCS评分。结果:在发病的初期,脑血肿扩大组患者的收缩压和舒张压均明显高于非脑血肿扩大组患者,差异显著,具有统计学意义(P<0.05);脑血肿扩大组患者发病时的年龄明显大于非脑血肿扩大组患者,差异显著,具有统计学意义(P<0.05);脑血肿扩大组患者的丘脑出血率、血肿形态不规则率、死亡率均明显高于非脑血肿扩大组患者,差异显著,具有统计学意义(P<0.05);脑血肿扩大组中发病后GCS评分较正常人低≥2分的患者所占的比率明显高于非脑血肿扩大组中发病后GCS评分较正常人低≥2分的患者所占的比率,差异显著,具有统计学意义(P<0.05)。结论:在脑出血的早期脑血肿扩大与患者的年龄、血肿的部位和形态、发病初期的血压有关,其中血压是可控因素。临床医师应积极控制脑出血患者的血压,以降低其早期脑血肿扩大的发生率,改善其预后,降低其死亡率。

To explore the effects of hypertension on enlargement of hematoma derived from early-stage cerebral hemorrhage . Methods: A total of 193 cerebral hemorrhage patients , including 109 males and 84 females, who were aged from 45~78. The patients were divided into two groups according to whether the hematoma enlarged : no enlargement group(92 males and 70 females, aged 45~68 years old with a mean age of 56.9), enlargement group(17 males and 14 females, aged 55~78 years old with a mean age of 66.2). Analyze the fluctuation of the blood pressure at the onset of the hemorrhage episode, onset age, history of hypertension, location and conformation change of the hematoma. Results There was significant difference in blood pressure at the onset of the cerebral hemorrhage episode between two groups of patients, p<0.05. The onset age of the enlargement group is older, p<0.05. As for the location, hematoma of the thalamus is most likely to enlarge. Conclusion: It is demonstrated that the enlargement of early-stage cerebral hematoma is associated with many factors, such as age, history of alcohol abuse, liver dysfunction, coagulation dysfunction, location and conformation of hematoma, and elevated blood pressure at the onset of the episode. Of all the above factors, blood pressure can be controlled effectively. So well-controlled blood pressure can benefit the patients by decreasing the mortality rate and the occurrence of the enlargement of the early-stage hematoma.