Effect Of Blood Pressure Management On Short-term Prognosis In Patients With Acute Cerebral Hemorrhage

ObjectiveExplore the influences of blood pressure management on short-term prognosis ofpatients with acute hypertensive cerebral hemorrhage in acute period through bloodpressure monitoring and management. Provide the basis for the management of bloodpressure in patients with acute hypertensive cerebral hemorrhage patients.MethodsA prospective observational study of120patients within24hours after the onsetof acute hypertensive cerebral hemorrhage, the patients were divided into controlgroup of60cases and a control group of60cases according to the systolic bloodpressure(>150mmHg) on admission. Setting management target blood pressure: SBP100~150mmHg. Use ECG monitor or mercury sphygmomanometer monitor tomeasure the blood pressure q0.5h~q4h within7days of admission, use mercurysphygmomanometer measurement to measure the contralateral brachial artery bloodpressure in q6h~Q8h7~15days. Record neurological function, death and seriousadverse events after1months since onset. The data were analyzed by SPSS17.0. ResultsThis study included120cases of patients with hypertensive cerebralhemorrhage in acute period.60cases management group,60cases in the controlgroup. The differences of clinical baseline data between these two groups was notsignificant (P>0.05). Blood pressure in the management group were significantlydecreased within24h after admission. In acute period, two groups both showedautomatic blood pressure lowering trend. For patients with acute hypertensivecerebral hemorrhage blood who underthrough blood pressure management objectivescan significantly reduce hematoma enlargement. In management group, hematomaenlargement ratio was15.73±42.94%, while the control group was39.06±43.47%. Results there was significant difference between two groups (P<0.05). Afteradmission, the patients with blood pressure fluctuations within the target rangemanagement group, had better the recovery of neurological function and lowermortality1months after onset. Control group60cases, neurological function score(NIHSS):4.15±2.06, NIHSS%:75.32%;60cases in the control group, theneurological function score (NIHSS):8.84,5.92, NIHSS%:46.52%. The neurologicalfunction score of the two groups were significantly different (P<0.05). Inmanagement group,2cases died, mortality was3.33%; In control group，8casesdied, mortality was13.33%, there was significant difference between the two groups(P<0.05). Serious adverse events： management group had severe hypotension,ischemic stroke, cardiovascular events, such as expanding the area of cerebralhemorrhage incidence was significantly lower than that of the control group,（P<0.05）. Conclusions1． In patients with acute hypertensive cerebral hemorrhage, early use ofantihypertensive drugs on blood pressure target could control the increase ofhematoma.2． Monitoring of blood pressure after the onset, the patients with the bloodpressure controlling to the target value, showed better neurological function recoveryand higher survival rate after1month. The patients whose blood pressure is higher orlower than the target value showed poor recovery of neurological function and highmortality after1month.3．For patients with acute hypertensive cerebral hemorrhage，early intensiveantihypertensive management, showed no serious adverse reaction in clinical practiceand it is safe and feasible.