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纸质出版:2016
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张钶,霍钢,王晓澍,杨刚,郑履平.早期强化降压对高血压脑出血患者颅内血肿及水肿的影响[J].陆军军医大学学报(原第三军医大学学报),2016,38(07):757-760.
Zhang Ke,Huo Gang,Wang Xiaoshu,Yang Gang,Zheng Lyuping.Effect of early intensive antihypertensive treatment on hematoma and perihematomal edema in patients with hypertensive intracerebral hemorrhage[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(07):757-760.
张钶,霍钢,王晓澍,杨刚,郑履平.早期强化降压对高血压脑出血患者颅内血肿及水肿的影响[J].陆军军医大学学报(原第三军医大学学报),2016,38(07):757-760. DOI:
Zhang Ke,Huo Gang,Wang Xiaoshu,Yang Gang,Zheng Lyuping.Effect of early intensive antihypertensive treatment on hematoma and perihematomal edema in patients with hypertensive intracerebral hemorrhage[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(07):757-760. DOI:
目的 探讨早期强化降压对高血压脑出血患者颅内血肿扩大及血肿周围水肿的影响。 方法 回顾性分析本院2013年9月至2015年6月收治的幕上高血压脑出血患者的临床资料,根据我院神经内、外科对高血压脑出血早期血压管理方式的不同,将病例资料分为强化降压组(3 h内收缩压降至≤140 mmHg,并维持120~140 mmHg 1周)和对照组(目标收缩压160~180 mmHg,平均动脉压100~130 mmHg)。分别从年龄、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、收缩压、起病后干预时间、血肿体积5个方面分层次比较2组3 d内血肿扩大发生率,并计算相对危险度降低率(relative risk reduction,RRR),对比2组第3、7、14天水肿变化。 结果 共筛选出90例行强化降压幕上高血压脑出血患者的临床资料,再筛选出与之相匹配的对照组90例,2组的一般资料比较差异无统计学意义(P0.05)。强化降压组血肿扩大9例(10.0%),对照组血肿扩大24例(26.7 %),差异有统计学意义(P0.01),RRR值为62.5%(95%CI为23.9%~81.5%)。2组水肿量在第3、7、14天差异无统计学意义(P0.05)。 结论 脑出血早期强化降压能减少患者颅内血肿扩大概率,不增加血肿周围水肿体积。
Objective To determine the effect of early intensive blood pressure-lowering treatment on the hematom volume and perihematoma edema in the patients with hypertensive intracerebral hemorrhage. Methods Clinical data of the patients with supratentorial hypertensive intracerebral hemorrhage who received hypertensive intracerebral hemorrhage treatment within 6 h of onset and admitted in our hospital from September 2013 to June 2015 were retrospectively collected in this study. According to the different managements of hypertensive intracerebral hemorrhage by the neurology department and the neurosurgery department
the patients were divided into intensively antihypertensive group (systolic blood pressure was decreased to ≤140 mmHg
and maintained at 120~140 mmHg for 1 week) and control group (systolic blood pressure target 160~180 mmHg
mean arterial pressure 100~130 mmHg). The age
Glasgow coma scale (GCS)
systolic blood pressure
intervention time after the onset
and hematoma volume were compared between the 2 groups. The incidence of hematoma expansion within 3 d and relative risk reduction (RRR) were observed. The edema volume at 3
7 and 14 d were compared between the 2 groups. Results There were 90 patients with supratentorial hypertensive intracerebral hemorrhage and receiving intensive antihypertensive treatment enrolled in this study
and another 90 patients undergoing common antihypertensive treatment who were matched with intensively antihypertensive group in general data (P0.05). Nine cases in the intensively antihypertensive group (10%) had hematoma enlargement
and 24 cases in the control group (26.7%)
with significant difference between the 2 groups (P<0.01). RRR was 62.5%
with 95%CI ranging from 23.9% to 81.5%. There was no difference in the hematoma volume at 3
7 and 14 d between the 2 groups (P0.05). Conclusion Early intensive antihypertensive treatment reduces the incidence of hematoma enlargement
but not increases perihematoma edema volume.
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