中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2012年
4期
302-304
,共3页
脑出血%降压,控制性
腦齣血%降壓,控製性
뇌출혈%강압,공제성
Cerebral hemorrhage%Hypotension controlled
目的 观察差别化降血压治疗不同出血量的老年急性脑出血患者的临床疗效. 方法选择老年急性脑出血伴高血压患者共86例,随机分为积极降压组和常规降压组,每组各43例.出血量＜30 ml为小出血量,出血量≥30 ml为中大出血量.积极降压组在开始治疗后的1 h内首选静脉降压药物使收缩压降至140～160 mm Hg;常规降压组早期控制收缩压至180～200 mm Hg.分别于治疗前及治疗后3d、7d时测定血肿体积,治疗前及治疗后7d和28 d进行美国国立卫生研究院卒中量表(NIHSS)评分,评价治疗后28 d的临床疗效. 结果 积极降压组的小出血量患者治疗后28d的NIHSS评分(4.8±2.7)分、治疗后3d的血肿体积增大(2.4±0.6) ml和治疗第28天总显效率86.67％均优于常规降压组(7.6±3.9)分、(8.1±3.1)ml和53.13％(t=3.27、9.84,x2=8.20,均P＜0.01),而中大出血量患者的组间比较差异均无统计学意义(均P＞0.05). 结论 积极降压治疗能抑制小出血量脑出血患者早期血肿体积增大、改善患者预后、提高临床疗效；而对中大出血量患者并无明显的临床作用,甚至可能对部分患者不利.
目的 觀察差彆化降血壓治療不同齣血量的老年急性腦齣血患者的臨床療效. 方法選擇老年急性腦齣血伴高血壓患者共86例,隨機分為積極降壓組和常規降壓組,每組各43例.齣血量＜30 ml為小齣血量,齣血量≥30 ml為中大齣血量.積極降壓組在開始治療後的1 h內首選靜脈降壓藥物使收縮壓降至140～160 mm Hg;常規降壓組早期控製收縮壓至180～200 mm Hg.分彆于治療前及治療後3d、7d時測定血腫體積,治療前及治療後7d和28 d進行美國國立衛生研究院卒中量錶(NIHSS)評分,評價治療後28 d的臨床療效. 結果 積極降壓組的小齣血量患者治療後28d的NIHSS評分(4.8±2.7)分、治療後3d的血腫體積增大(2.4±0.6) ml和治療第28天總顯效率86.67％均優于常規降壓組(7.6±3.9)分、(8.1±3.1)ml和53.13％(t=3.27、9.84,x2=8.20,均P＜0.01),而中大齣血量患者的組間比較差異均無統計學意義(均P＞0.05). 結論 積極降壓治療能抑製小齣血量腦齣血患者早期血腫體積增大、改善患者預後、提高臨床療效；而對中大齣血量患者併無明顯的臨床作用,甚至可能對部分患者不利.
목적 관찰차별화강혈압치료불동출혈량적노년급성뇌출혈환자적림상료효. 방법선택노년급성뇌출혈반고혈압환자공86례,수궤분위적겁강압조화상규강압조,매조각43례.출혈량＜30 ml위소출혈량,출혈량≥30 ml위중대출혈량.적겁강압조재개시치료후적1 h내수선정맥강압약물사수축압강지140～160 mm Hg;상규강압조조기공제수축압지180～200 mm Hg.분별우치료전급치료후3d、7d시측정혈종체적,치료전급치료후7d화28 d진행미국국립위생연구원졸중량표(NIHSS)평분,평개치료후28 d적림상료효. 결과 적겁강압조적소출혈량환자치료후28d적NIHSS평분(4.8±2.7)분、치료후3d적혈종체적증대(2.4±0.6) ml화치료제28천총현효솔86.67％균우우상규강압조(7.6±3.9)분、(8.1±3.1)ml화53.13％(t=3.27、9.84,x2=8.20,균P＜0.01),이중대출혈량환자적조간비교차이균무통계학의의(균P＞0.05). 결론 적겁강압치료능억제소출혈량뇌출혈환자조기혈종체적증대、개선환자예후、제고림상료효；이대중대출혈량환자병무명현적림상작용,심지가능대부분환자불리.
Objective To observe the the therapcutic efficacy of differential antihypertensive treatments on the elderly acute cerebral hemorrhage with different amounts of bleeding. Methods 86 elderly patients with acute cerebral hemorrhage combined by hypertension were randomly divided into two groups:active antihypertensive group and regular antihypertensive group (n=43 for each group),among which 62 cases aged (68.9±5.3) years were in hemorrhage of small amount (volume ＜30 ml),24 cases aged (70.8 ± 5.7) years in large amount hemorrhage (volume ≥30 ml).The patients in active antihypertcnsive group received intravenous antihypertensive drugs within 1 hour of treatment in the following 7 d to reach systolic pressure 140-160 mm Hg.In contrast,in the control group the patients' systolic pressure reached 180-200 mm Hg at early stage.The hematoma volume was measured by CT before treatment and at 3 d and 7 d after treatment.NIH stroke scale (NIHSS)was used before treatment and 7 d and 28 d after treatment Results In the patients with small amount of bleeding,NIHSS scores and the total efficacy rate at 28 d after treatment and hematoma size at 3 d after treatment were better in active antihypertensive group than in regular antihypertensive group [(4.8±2.7) scores,86.67％ aud (2.4±0.6) ml vs.(7.6±3.9) scores,53.13％ and (8.1±3.1) ml,all P＜0.01]. However,for the patients with large amount of bleeding,there were no statistical differences in the above indexes between the two differential strategies (all P＞0.05).Conclusions Active antihypertensive therapy may inhibit early hematoma volume,improve prognosis and enhance clinical efficacy for the patients with small bleeding,but no clinical significance for the patients with large amount of bleeding.
