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目的探讨严格的血压管理对急性颅内动脉瘤破裂出血术后患者目标血压的控制效果。方法对2015年1月—9月28例颅内动脉瘤破裂出血术后患者进行严格的血压调控和监护。结果 28例患者的血压经专科对症治疗及综合的血压管理,均得到较好控制。21例单个动脉瘤术后患者平均动脉压控制在90~110 mm Hg(1 mm Hg=0.133 k Pa),收缩压控制在135~160 mm Hg;7例多个动脉瘤术后患者平均动脉压控制在80~100 mm Hg,收缩压控制在135~150 mm Hg。21例患者血压在24 h内降至理想水平,7例患者血压在48 h内降至理想水平,患者未出现颅内再出血。27例患者呼吸机辅助呼吸5~7 d后顺利停机拔管,转入神经外科病房继续治疗;1例患者于术后第2天自动出院。结论对急性颅内动脉瘤破裂出血术后患者采取有效的血压管理,可以减少患者术后并发症。
Objective To investigate the effect of strict blood pressure management on the target blood pressure in patients with acute intracranial aneurysm rupture after operation. Methods Twenty-eight patients with ruptured intracranial aneurysm underwent severe blood pressure control and monitoring from January 2015 to September 2015. Results The blood pressure of 28 patients was well controlled by specialist symptomatic treatment and comprehensive blood pressure management. The average arterial pressure in 21 patients with single aneurysm was controlled at 90-110 mm Hg (1 mm Hg = 0.133 kPa) and the systolic blood pressure was controlled at 135-160 mm Hg. The average arterial pressure Control of 80 ~ 100 mm Hg, systolic blood pressure control in the 135 ~ 150 mm Hg. In 21 patients, the blood pressure dropped to the ideal level within 24 hours. In 7 patients, the blood pressure dropped to the ideal level within 48 hours. No intracranial hemorrhage occurred in the patients. 27 patients ventilator-assisted respiration 5-7 days after the smooth shutdown down into the neurosurgical ward to continue treatment; 1 patient was discharged on the first 2 days after surgery. Conclusion Effective blood pressure management in patients with acute intracranial aneurysm rupture can reduce the postoperative complications.