Effects Of Early Blood Pressure-lowering Treatment On The Growth Of Hematoma In Hypertensive Intracerebral Hemorrhage

Subject:Objective To investigate effects of early blood pressure-lowering treatment on the growth of hematoma in hypertensive intracerebral hemorrhage. Methods:A series of88patients who were in accordance with the inclusion criteria was analyzed.The sex,age and past history of the patients,the bleeding site,the blood pressure were all recorded.All patients underwent first CT immediately on admission,second CT were underwent immediately when the patients’neurological function deteriorated progressively,or second CT were underwent at24hours after ictus if patients’clinical symptom were stable.Hematoma volume in the first CT(V1)and the second CT(V2)were measured.The longest diameter(A)of the hematoma and the second diameter(B)on the perpendicular line were measured in the slice with the largest area of ICH.The height of the hematoma was calculated by multiplying the number of slices involved by slice thickness,providing the third diameter(C).The3diameters were multiplied and then divided by2(A×B×C/2)to obtain the volume of ICH. Hematoma enlargement was defined as an increase in volume of140%or12.5cm3. The patient can be diagnosed hematoma enlargement.According to the Systolic Blood Pressure,the patients were divided into three groups;group Ⅰ:140mmHg≤SBP≤159mmHg; group Ⅱ:160mmHg≤SBP≤179mmHg; groupⅢ:SBP≥180mmHg.According to the regulation of the Systolic Blood Pressure,the patients were divided into two groups;group A:SBP<160mmHg,group B:SBP>160mmHg.Discuss the relationships between the blood pressure regulation and hematoma enlargement during acute stage of hypertensive cerebral hemorrhage. The results was analyzed by SPSS(version13.0).Measurement data and numeration data were compared with t test and χ2test,respectively,and P<0.05was considered to be statistically significant.Results:The patients’blood pressure is higher,especially within6hours.3of24patients in Ⅰ group(140mmHg≤SBP≤159mmHg),blood tumor extended.The ratio of extention is12.50%.17of44patients in II group(160mmHg≤SBP≤179mmHg),blood tumor extended.The ratio of extention is38.64%.14of20patients in Ⅲ group(SBP≥180mmHg),blood tumor extended.The ratio of extention is 70.00%.Compaired the ratio of extention of the three group with the χ2test,the different is significanty.(P<0.05).The relationship of regulation of blood pressure and blood tumor enlargement:group A(SBP<160mmHg),the ratio of extention is27.08%;group B(SBP>160mmHg)the ratio of extention is52.50%.Compaired the ratio of extention of the three group with the χ2test the different is significantly.Conclusion:1.High SBP is one independent risk factors of the blood tumor extention.2. The patients whose SBP is higher than180mmHg is easily have the blood tumor extended,So is the patients whose SBP can not be effectively controlled.The patients whose SBP is lower than160mmHg is rare have the blood tumor extended.3. The control of the blood pressure has close relationship with the extention of the blood tumor.