高血压脑出血早期降压对血肿扩大的影响

目的 探讨高血压脑出血患者早期血压调控对血肿扩展的影响.方法 选择入院时血压＞180/100 mm Hg的高血压脑出血患者96例,按随机数字表法分为早期强化降压组（强化降压组）48例,指南标准降压组（指南降压组）48例,分别予以相应降压治疗.观察24 h后两组血肿体积变化,以及入院时和入院后21 d美国国立卫生研究院脑卒中量表（NIHSS）评分情况.结果 强化降压组血肿扩大5例（10.42%）,指南降压组血肿扩大11例（22.92%）,强化降压组血肿扩大率显著低于指南降压组（P＜0.05）.两组入院后第21日NIHSS评分分别为（17.2±8.25）分和（20.8±9.12）分,两组比较差异有统计学意义（P＜0.05）.结论 早期强化降压能有效预防血肿扩大,改善预后.

Influence of the Early Antihypertensive Therapy on Hematoma Enlargement in Patients with Hypertension Intracerebral Hemorrhage

Objective To study the influence of the early intensive antihypertensive therapy on hematoma enlargement in patients with hypertension intracerebral hemorrhage. Methods Ninety-six acute intracerebral hemorrhage patients with blood pressure 〉 180/100 mm Hg were divided into two groups by the random number table ：48 cases of the early strengthened antihypertensive group （strengthened group） and 48 cases of the standard guidance antihypertensive group （ guidance group）, both of which were given corresponding treat- ment. The National Institutes of Health Stroke Scale （NIHSS） before and after 21 d of treatment, and the hematoma volume after 24 h treatment were observed. Results Hematoma expansion happened in 5 cases in the strengthened group （10.42%） and in 11 cases in the guidance group （22.92%）. The difference between the two groups was statistically significant（ P 〈 0.05 ）. The difference between the NIHSS of the two groups was significant after 21 d treatment （ P 〈 0.05 ）, with the former of 17.2 ± 8.25 and the latter of 20.8 ±9.12. Conclusion Early intensive antihypertensive therapy is helpful to control hematoma enlargement and improve the prognosis.