[摘要] 目的 探讨高血压脑出血患者的临床急救措施及其效果。方法 随机选取2012年9月—2013年9月在该院收治的高血压脑出血患者240例,根据患者脑出血量的不同,合理选择治疗方案。如果患者脑出血量小,则采用内科控制,如果患者脑出血量大,则采用外科手术治疗,观察急诊脑出血患者的临床治疗效果。结果 采用内科治疗患者中,由于控制病情的效果不理想,转外科手术治疗;而实施外科手术治疗的患者,治疗效果良好,病情得以缓解。由于脑出血量大,6例患者错过最佳时机,治疗无效死亡。结论 根据脑出血患者病情的不同,合理确定治疗方案,对于改善患者病情,降低死亡率,具有重要的作用。 [关键词] 高血压;脑出血;临床效果 [中图分类号] R743.34 [文献标识码] A [文章编号] 1674-0742(2014)11(c)-0017-02 [Abstract] Objective To investigate the clinical emergency treatment measures for patients with hypertensive cerebral hemorrhage and the therapeutic effects. Methods 240 patients with hypertensive cerebral hemorrhage admitted in our hospital from September 2012 to September 2013 were randomly selected. Reasonable therapeutic regimen was given to the patients according to the different volume of cerebral hemorrhage. Internal medicine treatment was given to the patients with small amount of cerebral hemorrhage, and surgical treatment was given to the patients who had large amount of cerebral hemorrhage. And the clinical treatment effect of the emergency patients with cerebral hemorrhage was observed. Results Of the patients treated by internal medicine, some were given surgical treatment later due to the unideal therapeutic effect of internal medicine; the conditions of the patients with surgical treatment were alleviated because the curative effect was good, but 6 patients with large volume of cerebral hemorrhage died because they missed the best treatment time and were unresponsive to the therapy. Conclusion Determining a reasonable therapeutic regimen based on the conditions of the patients with cerebral hemorrhage is very important for improving the disease of the patients and reducing the mortality. [Key words] Hypertension; Cerebral hemorrhage; Clinical effect 随着经济发展水平的提高,人们的生活水平得到了显著提高,但是高血压脑出血的发病率却大幅上升。在高血管疾病中,脑血管的致死率已上升到70%,比例相当高[1]。因此,高度重视脑出血患者的治疗,提高脑出血急诊的临床治疗效果,具有重要的现实意义。不过从实际情况看,高血压脑出血抢救效果,整体不容乐观[2]。该研究2012年9月—2013年9月期间探讨急诊脑出血患者的临床分析,现报道如下。 1 资料与方法 1.1 一般资料 随机选取在该院收治的高血压脑出血患者240例,男性156例,女性84例,患者年龄41~82岁,平均年龄(63.4±3.5)岁。所有患者中,84例收缩压<180 mmHg患者,108例患者收缩压在180~195 mmHg,>195 mmHg的48例。而舒张压<105 mmHg患者82例,>105 mmHg158例。脑出血部位,174例为内囊基底、22例丘脑、6例额叶、8例脑干、26例颞顶和4例小脑。240例患者全是突发性脑出血,CT 检查(型号为东芝/toshiba/TOSCANER)与MRI 检查(型号为MAGNETOM Sonata)结果显示,无脑血管炎、脑动脉瘤和凝血功能差等导致的出血,且患者均有的呕吐、大汗和呼吸微弱等临床症状。根据格拉斯昏迷指标评分,78例<5 分,144例评分6~8 分,18例>9分。 1.2 方法 |