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华西医学  2013 

缺血性脑卒中患者溶栓前血压管理现状分析

DOI: 10.7507/1002-0179.20130206, PP. 647-650

Keywords: 血压,血管状态,溶栓,脑卒中

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Abstract:

目的 探索缺血性脑卒中患者溶栓前血压管理和预后的相关性,并分析溶栓前血压管理考虑颅内外血管状态的必要性。方法 计算机检索PUBMED数据库,并辅以其他检索,对所有涉及溶栓前血压的文献进行整理,并根据“溶栓类型、是否进行溶栓前血压管理、是否进行溶栓前血管评估”对文献进行分类,对其溶栓后的症状性颅内出血率进行分析对比。结果 大多数静脉溶栓文献无血管评估的数据,其出血率波动于较高水平;进行了血管评估,而未提及血压管理或虽未进行血压管理,但所有患者的血压符合指南中对于血压的要求的文献也呈现了较高的出血率;有1篇进行了血管评估的动脉溶栓文献没有症状性颅内出血事件发生。结论 当前证据表明现有的溶栓前血压管理模式还不够完善,这也在一定程度上可以解释目前较高的溶栓后症状性出血率。合理的溶栓前血压管理模式有待进一步探索。溶栓前血压管理考虑颅内外血管状态,根据血管病变程度对溶栓前血压进行分级管理可能会成为一个较佳的血压管理模式。

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