陈茂君，李　莉，崔文耀，李　浩



两种血压管理方法在青年高血压脑出血患者中的应用效果

陈茂君，李莉，崔文耀，李浩

目的探讨两种血压管理方法在青年高血压脑出血患者中的应用效果。方法2013年3月～2015年3月，纳入符合抽样标准的青年高血压脑出血患者162例，随机分为观察组与对照组，各81例。对照组采用传统血压治疗管理法，不设定目标血压；观察组采用早期快速强化降压法，静脉泵入短效降压药，2 h内将血压降至目标血压（140/90mmHg）以下，并保持血压稳定。分别于治疗前后行临床神经功能缺损程度评分（CCSS）、改良Rankin量表（mRS）评分和头颅CT检测，计算神经功能恢复情况及血肿扩大例数。结果观察组脑血肿体积扩大率小于对照组（P＜0.05）；对照组的CCSS评分及mRS评分均高于观察组（P＜0.05）。结论对青年高血压脑出血患者给予早期快速强化降压治疗，对预防患者脑血肿扩大及促进神经功能恢复有积极作用。

青年；高血压；脑出血；血压管理

[Abstract]Objective To explore the application effects of two blood pressure managementmethods on young hypertensive cerebral hemorrhage patients.Methods Between March 2013 and March 2015,162 cases of young hypertensive cerebral hemorrhage patientsmeeting the sampling standard were enrolled and random ly and averagely divided into observation and control groups.The control group was treated by conventional blood pressure managementmethod which did not set the target value.The observation group was treated by super-early strengthening antihypertensivemethod which pumped short-acting antihypertensive drugs via veins in order to decrease blood pressure to the target value of 140/90mmHg within two hours and keep the blood pressure stable.Before and after the treatment,the CCSS,the modified Rankin Scale(mRS),and brain CT scanning were carried out.Calculation wasmade in recovery of neurological function and the number of hematoma enlargement cases.Results The cephalophyma enlargement rate in the observation group was smaller than that in the control group(P＜0.05).The CCSSandmRS scores of the control group were all higher than those of the observation group(P＜0.05).Conclusion Super-early strengthening antihypertensivemethod can reduce hematoma enlargement and improve the neurological function recovery of the young hypertensive cerebral hemorrhage patients.

[Keywords]youth;hypertension;cerebral hemorrhage;blood pressuremanagement

青年高血压脑出血是指年龄18～44岁的成人由于高血压和脑动脉硬化自发出现的脑实质内出血，其危险因素及发病率均与中老年脑出血有所不同，有着起病急、病情重、变化快的特点[1]。脑出血发生后，血压因颅内压变化及血管调节系统受损而发生相应改变，脑出血早期短暂的血压增高，可影响脑组织的血流灌注，甚至引起血肿扩大，并危及生命。因此，早期血压管理对青年高血压脑出血的救治至关重要[2]。本研究探讨快速强化降压和传统降压治疗两种血压管理方法对青年高血压脑出血患者血肿扩大及神经功能缺损程度的影响，为制订临床血压管理标准化方案提供参考依据。……