规范化血压管理与治疗对急性脑出血(基底节区)预后影响的临床研究
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Empirical study on the relationship between commanding blood pressure and prognostic condition from 82 cases following acute cerebral hemorrhage
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    目的:观察规范化血压管理与治疗对急性脑出血(基底节区)预后的影响,探讨分期和规范化管理血压的可行性-方法:对发病12 h内入院的脑出血(基底节区)患者随机分组,记录患者95版中国脑卒中临床神经功能缺损程度评分量表(简C表)-斯堪的那维亚卒中量表(scandinavian stroke scale,SSS,简S表)神经功能评分的均数变化(入院-1周-2周-3个月),用“预先设定血压目标范围”和“分期-选药-联合-全面达标”原则控制血压(规范的血压管理治疗)为研究因素,比较治疗组(规范的血压管理治疗,n = 41)与对照组(传统血压管理治疗,n = 41)3个月内的转归变化-结果:①3个月内治疗组的病死率低于对照组(P < 0.01),治疗有效率高于对照(P < 0.01);②治疗2周后,治疗组神经功能评分较对照组比较差异显著(C表2周-3个月, P < 0.01;S表2周-3个月,P < 0.01);③治疗组和对照组分别与入院时配伍比较,神经功能评分均有显著差异(P < 0.01),表明两种治疗均有疗效-但治疗效果与入院评分不相关(P > 0.05);④回归分析表明:神经功能保留情况(3个月时与入院时c评分差值)与年龄-性别及入院时出血量之间均无线性关系-结论:对脑出血(基底节区)进行规范的血压管理是可行的;本次研究中接受规范化血压管理治疗方案的患者更受益-

    Abstract:

    Objective:To observe the effects of commanding blood pressure on prognostic condition of cerebral hemorrhage and to explore how to do. Methods:82 patients with cerebral hemorrhage(the basal regions) were divided into two groups randomly:one group(the treated group, n = 41) received a standardized command of blood pressure which included both a individual-based value range in blood pressure and a standardized treatment based on staging, drug selection, drug combination and overall target getting, and the control group(n = 41) received a traditional commanding of blood pressure. Two groups were scored with both The Chinese Stoke Clinical Scale(1995,CCSS) and Scandinavian Stroke Scale(SSS) on the day after stoke, 7days, 14days and 3months each following. The scores were statistically analyzed. Results:①The death ratio(within 3 months) in the treated group was lower than that in the control group(P < 0.01). ②The scores in the treated group were more energetic in maintain the neurons function than in the control group(CCSS,2w,3m,P < 0.01;SSS 2w,3m,P < 0.01). ③Compared pairedly with the group’s which had been not hospital cared still, the scores of the others in both the treatment and the control were changed effectively(P < 0.01). But not find a correlation between the scores of the groups after treatment and that before treatment(P < 0.01), which means prognostic condition maybe independent from the scores of the groups before treatment. ④By the way of regression analysis, not find a coefficient between the prognostic condition and each cases among age, sexuality and the amount of hemorrhage(r = 0.256,0.273,0.595). Conclusion:Commanding blood pressure standardized by the way of staging and principle above was feasible, and the standard commanding was beneficial to patients in acute cerebral hemorrhage.

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刘文旭,潘 晖,李晓波.规范化血压管理与治疗对急性脑出血(基底节区)预后影响的临床研究[J].南京医科大学学报(自然科学版),2009,29(4):520-523

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  • 收稿日期:2008-04-22
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