高血压脑出血开颅患者急性期血压调控及预后临床观察.docVIP

高血压脑出血开颅患者急性期血压调控及预后临床观察 　　【摘要】 目的 观察高血压脑出血行开颅术患者急性期血压调控及对临床预后的影响。方法 将62例高血压脑出血行开颅血肿清除术患者，随机分为两组，观察组 (n=31)急诊入院后即给予微量泵静脉注射乌拉地尔，监测控制血压低于150/90 mm Hg(MAP≤110 mm Hg)；对照组(n=31)采用常规术前治疗，监测控制血压低于180/105 mm Hg(MAP≤130 mm Hg)。术后根据病情给予常规降压治疗。比较两组患者的病死率，术后再出血率等并发症及近、远期疗效的差异。结果 观察组死亡3例，无术后再出血；对照组死亡5例，术后再出血2例，两组病死率、再出血率及术后并发症无统计学差异；近期GOS预后比较：观察组优7例，良10例，对照组优3例，良6例，两组总优良率差异有统计学意义(χ?2=4.23，P0.05)；两组患者远期ADL评分的比较观察组优于对照组(P0.05)。结论 高血压脑出血行开颅血肿清除术患者急性期强化降压优于常规术前治疗，能提高患者的近、远期预后。? 　　【关键词】 　　高血压脑出血；开颅术；血压调控；预后 　　?? 　　Clinical observation of blood pressure regulation in acute phase and prognosis in craniotomy patients with hypertension cerebral hemorrhage 　　 　　YANG Fan，SHEN Ming-feng, YAO Hong-wei, et al.The First People?s Hospital of Shangqiu City, Shangqiu 476100, China 　　? 　　【Abstract】 Objective 　　To observe the blood pressure regulation in craniotomy patients with acute hypertension cerebral hemorrhage and its impact on clinical prognosis. Methods 62 cases of craniotomy patients with acute hypertensive cerebral hemorrhage were randomly divided into two groups, the control group (n=31) was treated with conventional preoperative therapy, keep monitoring blood pressure below 180/105 mm Hg (MAP=130 mm Hg).While urapidil was used through microinfusion pump to the observation group (n=31)based on it after admission, keep monitoring of blood pressure under 150 /90 mm Hg (MAP=110 mm Hg)，both groups were treated with conventional antihypertensive treatment after operation.The difference of postoperative complications such as mortality，rehaemorrhagia rate and short time effect and prostecdtive efficacy was compared between the two groups. Results There was no significant difference between the two groups on mortality and rehaemorrhagia (the observation group：3 cases of death, no rehaemorrhagia; the control group：5 cases of death, 2 cases rehaemorrhagia), GOS recent prognosis comparison: the observation group was excellent(good recovery) in 7 cases, good(moderate disability) in 10 ca