急性重症脑梗死患者早期血压调控对预后的影响.docxVIP

急性重症脑梗死患者早期血压调控对预后的影响 刘博娃 石秋艳 孙原 李弘 杨延雯 摘要 目的 探讨急性重症脑梗死患者急性期早期进行血压调控对患者预后的影响，为急性重症脑梗死患者早期血压的控制提供临床依据。方法 选取20XX年2—11月符合入选标准的128例急性重症脑梗死患者为研究对象，按照组间基线特征匹配的原则分为血压调控组63例和对照组65例。血压调控组3天内实现收缩压低于140mmHg，但不能低于130mmHg。對照组急性期采用指南推荐降压范围（收缩压不高于180mmHg不予降压药，高于180mmHg时给予降压药物，但不低于141mmHg），采取美国国立卫生研究院卒中量表（NIHSS）评估患者发病后7、14、21天患者神经功能恢复情况;用改良Rankin量表（mRS评分）、Barthel指数评估患者90天生活依赖及自理能力;比较3个月内两组死亡率。结果 发病后7、14、21天血压调控组患者的NIHSS评分均低于对照组，差异有统计学意义（P0.05），90天mRS评分低于对照组、Barthel指数高于对照组，差异均有统计学意义（P0.05）。3个月内，血压调控组死亡5例，失访1人，死亡率为8.06%，对照组死亡13例，失访2人，死亡率为20.63%，差异有统计学意义（P0.05）。结论 急性重症脑梗死患者早期进行血压控制可改善患者的预后，且死亡率低于指南推荐降压范围，所以在急性重症脑梗死患者的早期可进行强化控制血压范围。 关键词 血压调控;血压控制范围;重症脑梗死;预后 中图分类号 R743.33 文献标识码 A 文章编号 1671-0223（2020）14-045-05 Abstract Objective To explore the effect of early stage blood pressure regulation on the prognosis of patients with acute severe cerebral infarction，so as to provide clinical basis for early stage blood pressure control in patients with acute severe cerebral infarction.Method Selection in February to November 20XX meets the critria for the 128 cases of acute severe cerebral infarction patients as the research object，according to the matching principle of baseline characteristics between groups，63 cases were divided into blood pressure control group and 65 cases were divided into control group.blood pressure control group 3 days to realize the systolic blood pressure was lower than 140mmHg，but cannot lower than 130mmHg systolic blood pressure， control group in the acute phase using the guidelines recommend step-down range （ blood pressure was not higher than 180mmHg not blood pressure medication，blood pressure was higher than 180mmHg to give antihypertensive drugs，but not less than 141mmHg systolic blood pressure）.The National Institutes of Health Stroke Scale （ NIHSS ） was used to evaluate the neurological function recovery of the patients on 7，14 and 21days after the onset of the disease.The Modified Rankin Scale，Barthel index was used to evaluate the patien