【摘要】：目的:探索高血壓腦出血術(shù)后患者接受鎮(zhèn)痛治療對血壓、意識狀態(tài)、術(shù)后再出血發(fā)生率的影響,探討高血壓腦出血術(shù)后患者鎮(zhèn)痛治療與控制血壓、防治術(shù)后再出血的應(yīng)用區(qū)間及治療策略。方法:選取2011年8月至2014年6月在山西醫(yī)科大學(xué)第一醫(yī)院急診科因高血壓腦出血收住院并行顳部開顱腦內(nèi)血腫清除術(shù)患者共50例,據(jù)其藥物特性,記錄應(yīng)用鹽酸丙帕他莫鎮(zhèn)痛治療(實驗組)與常規(guī)治療(對照組)患者之間不同時間點(diǎn)血壓、意識狀態(tài)、有無術(shù)后再出血等臨床指標(biāo),采用SPSS17.0軟件進(jìn)行計數(shù)資料獨(dú)立樣本t檢驗及計量資料卡方檢驗,分析所得結(jié)果。結(jié)果:昏迷組患者術(shù)后應(yīng)用鹽酸丙帕他莫1h平均動脈壓與常規(guī)治療組平均動脈壓進(jìn)行獨(dú)立樣本t檢驗,p值0.05,差異有統(tǒng)計學(xué)意義,余時間點(diǎn)p值0.05,無統(tǒng)計學(xué)意義;清醒-嗜睡組、朦朧組各時間點(diǎn)平均動脈壓經(jīng)獨(dú)立樣本t檢驗,p值0.05,無統(tǒng)計學(xué)意義;實驗組與對照組鎮(zhèn)痛與煩躁的發(fā)生率經(jīng)卡方檢驗p值0.05,差異有統(tǒng)計學(xué)意義;實驗組與對照組鎮(zhèn)痛與術(shù)后再出血的發(fā)生率經(jīng)卡方檢驗p值0.05,無統(tǒng)計學(xué)意義。結(jié)論:高血壓腦出血術(shù)后昏迷的患者應(yīng)用鹽酸丙帕他莫鎮(zhèn)痛對降低血壓、減小血壓波動幅度有積極作用;應(yīng)用鹽酸丙帕他莫可以減少高血壓腦出血術(shù)后患者煩躁的發(fā)生。
[Abstract]:Objective: to explore the effect of analgesic therapy on blood pressure, consciousness and the incidence of postoperative rebleeding in patients with hypertensive intracerebral hemorrhage after operation, and to explore the analgesic treatment and control of blood pressure in patients with hypertensive intracerebral hemorrhage. Application interval and treatment strategy for prevention and treatment of postoperative rebleeding. Methods: from August 2011 to June 2014, 50 patients with hypertensive intracerebral hemorrhage were selected from the Emergency Department of the first Hospital of Shanxi Medical University and treated with craniotomy for intracerebral hematoma clearance. Blood pressure, state of consciousness, postoperative bleeding and so on were recorded at different time points between patients treated with propatamol hydrochloride (experimental group) and routine therapy (control group). SPSS17.0 software was used to carry out t-test and chi-square test of counting data, and the results were analyzed. Results: the patients in coma group were treated with propanamol hydrochloride for 1 h mean arterial pressure after operation, and the average arterial pressure in routine treatment group was tested by t test (p = 0.05), the difference was statistically significant, and the remaining time point (p = 0.05) was not statistically significant. There was no significant difference in the mean arterial pressure between awake and sleepiness group and hazy group by t test of independent sample (p = 0.05), the incidence of analgesia and irritability in experimental group and control group was significantly higher than that in control group (p = 0.05). The incidence of analgesia and postoperative rebleeding in experimental group and control group was 0.05 by chi-square test (p = 0.05). Conclusion: propatamol hydrochloride has a positive effect on lowering blood pressure and reducing the fluctuation of blood pressure in patients with coma after hypertensive intracerebral hemorrhage and can reduce the occurrence of irritability in patients with hypertensive intracerebral hemorrhage after operation.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R651.1

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