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目的探讨早期强化降压治疗对高血压脑出血(HICH)患者血肿和神经功能的影响。方法选取2012年3月—2016年3月上海市宝山中西医结合医院收治的HICH患者80例,随机分为对照组和观察组,每组40例。两组患者入院后均接受常规治疗,观察组患者在常规治疗基础上加用氨氯地平进行早期强化降压治疗。比较两组患者治疗前及治疗后24 h、1个月血肿体积及美国国立卫生研究院卒中量表(NIHSS)评分,治疗24 h时血肿扩大情况。结果时间与方法在血肿体积上存在交互作用(P<0.05),时间在血肿体积上主效应显著(P<0.05),方法在血肿体积上主效应显著(P<0.05);治疗后24 h、1个月观察组患者血肿体积小于对照组(P<0.05)。治疗24 h时观察组患者血肿扩大发生率低于对照组(P<0.05)。时间与方法在NIHSS评分上存在交互作用(P<0.05),时间在NIHSS评分上主效应显著(P<0.05),方法在NIHSS评分上主效应显著(P<0.05);治疗后24 h、1个月观察组患者NIHSS评分低于对照组(P<0.05)。结论早期强化降压治疗可以有效控制HICH患者血肿扩大,促进患者神经功能康复。
Objective To investigate the effects of early intensive antihypertensive therapy on hematoma and nerve function in patients with hypertensive intracerebral hemorrhage (HICH). Methods Eighty HICH patients admitted to Shanghai Baoshan Hospital of Integrated Chinese and Western Medicine from March 2012 to March 2016 were randomly divided into control group and observation group, 40 cases in each group. Both groups received routine treatment after admission. The patients in the observation group were treated with amlodipine for the early stage of antihypertensive treatment on the basis of routine treatment. The hematoma volume and NIHSS score of 24 h and 1 h after treatment in both groups were compared, and the hematoma enlargement was observed at 24 h after treatment. Results The time and method had an interaction on hematoma volume (P <0.05), and the main effect of time on hematoma volume was significant (P <0.05). The main effect of hematoma volume on hematoma volume was significant (P <0.05) The volume of hematoma in observation group was less than that in control group in one month (P <0.05). The incidence of hematoma enlargement in observation group was lower than that in control group at 24 h after treatment (P <0.05). There was an interaction between time and method in the NIHSS score (P <0.05). The main effect of NIHSS score was significant (P <0.05), and the main effect of NIHSS score was significant (P <0.05) The NIHSS scores in the observation group were lower than those in the control group (P <0.05). Conclusion Early intensive antihypertensive treatment can effectively control the hematoma enlargement of HICH patients and promote neurological rehabilitation.