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【自救互救专题】之高血压急症的急救

时间:2019-6-9 13:43 0 185 | 复制链接 | 打印 | 上一主题| 下一主题
【自救互救专题】之高血压急症的急救

1、什么是高血压急症?

    高血压急症指血压明显升高(舒张压达120~130mmHg以上),同时合并靶器官损害需要住院和进行胃肠外药物治疗[1]。在高血压血症有多重表现形式,在治疗上也有很多差异。在降低血压的时候时要根据患者的个人情况制定相应的个体化的治疗方案。在降压时要逐步降压,不可操之过急。在最初1h内将血压降低约10%,随后2~4h内进一步将血压降低10%~ 15%,主动脉夹层例外[2]。每个患者的身体状况和并发症都不相同,在处理病情时要既要迅速又要谨慎,原则上静脉用药和口服用药相结合,以静脉用药为主。患者并发症不同,对降压的要求也不相同,当出现急性心梗、急性心衰时应立即进行降压治疗,以缓解病情。特别要指出,为了保证患者重要器官的血流灌注,首次降压不宜超过25%,血压维持在160/100mmHg左右,经过3~7d逐渐降压至理想水平。

    [1] 中国高血压防治指南修订委员会.中国高血压防治指南(2005年修订版)[J].高血压杂志, 2005, 134(增刊): 2- 41.
    [2]ELLIOTTW J. Clinical features in the managementof selected hy-pertensive emergencies [J]. Prog Cardiovasc Dis, 2006, 48(5):316- 325.

2、患者出现哪些情况须及时采取相应急救措施?
(辽宁卫生应急)

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