摘要
目的探讨不同血压控制水平对高血压脑出血(<30 mL)患者再出血风险及预后的影响。方法选取重庆市梁平区人民医院神经外科自2015年7月至2018年7月收治的符合纳入标准的245例患者的临床资料,以单双日随机分成2组,急性期均以静脉用药为主,血压平稳后以口服降压药为主,静脉用降压药为辅。对照组120例患者血压控制在140/80~160/100 mmHg(1 mmHg=0.133 kPa)、试验组125例患者血压控制在140/80 mmHg以下,分析2组患者的临床资料,比较2组患者再出血发生率、脑灌注压、临床神经功能缺损评分(FD)、总的生活能力状态(BI)以及预后情况。结果 2组患者的一般资料比较,差异无统计学意义(P>0.05);试验组再出血风险较对照组降低,差异有统计学意义(P<0.05);2组患者的血压控制范围内的脑灌注压比较,差异无统计学意义(P>0.05);2组发病后3、10、30 d、6个月的FD和BI指数比较,差异均无统计学意义(P>0.05);发病后半年对再出血患者随访发现,试验组较对照组恢复良好。结论血压控制在140/80 mmHg以下可降低再出血风险,改善再出血患者的预后。
Objective To explore the effect of different blood pressure control levels on the risk and prognosis of rebleeding in patients with hypertensive cerebral hemorrhage(<30 mL). Methods Two hundred and forty-five patients who met the inclusion criteria in the Department of Neurosurgery,Liangping District People’s Hospital from July 2015 to July 2018 were randomly divided into two groups by date. In acute phase, intravenous drugs were mainly used, oral antihypertensive drugs were mainly used after blood pressure was stable, and intravenous antihypertensive drugs were supplemented. The blood pressure of 120 patients in the control group was controlled at 140/80-160/100 mmHg(1 mmHg =0.133 kPa), and that of 125 patients in the experimental group was controlled below 140/80 mmHg. The clinical data of the two groups were analyzed, and the incidence of rebleeding, cerebral perfusion pressure, clinical neurological deficit score(FD), total living ability status(BI) and prognosis of the two groups were compared, as well as the relationship between rebleeding and prognosis. Results There was no significant difference between the two groups in terms of general data(P >0.05);the risk of rebleeding in the experimental group was lower than that in the control group(P <0.05);there was no significant difference between the two groups in terms of cerebral perfusion pressure within the control range of blood pressure(P >0.05);there was no significant difference between the two groups in the indexes of FD and BI at 3, 10, 30 d and 6 months after the onset of the disease(P >0.05);half a year after the onset of rebleeding patients were followed up and found that the experimental group recovered better than the control group. Conclusion Blood pressure control below 140/80 mmHg reduced the risk of rebleeding and improved the prognosis of rebleeding patients.
作者
刘皇勇
许民辉
Liu Huangyong;Xu Minhui(Department of Neurosurgery,Liangping District People's Hospital,Chongqing 405200,China;Department of Neurosurgery,Army Characteristic Medical Center,Chongqing 400000,China)
出处
《中华神经创伤外科电子杂志》
2020年第1期15-18,共4页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
基金
重庆市卫计委科研项目(2015zbxm051)
关键词
高血压脑出血
血压
再出血
预后
Hypertensive cerebral hemorrhage
Blood pressure
Rebleeding
Prognosis
