Panayiotou B N, Lloyd M, Fotherby M D, Crome P
Elderly Care Department, Manor Hospital, Walsall, Staffs, UK.
Int J Clin Pract. 1998 Apr-May;52(3):162-4.
Inappropriate management of high blood pressure in acute stroke can adversely affect outcome. We examined blood pressure evaluation and antihypertensive therapy during the first week post-stroke in 40 patients at a district general hospital with no stroke unit. In the first 24 hours, median frequency of blood pressure recording was 3 (range 1-12). After day 1, 11 (28%) had no blood pressure readings for one or two consecutive days. The side of measurement was not recorded in any patient. None of the 22 hypertensives (55%) had a bilateral measurement to exclude interarm inequality, and only 3 (7%) of all patients had postural readings to exclude orthostatic hypotension. Fourteen (35%) received antihypertensive therapy without meeting recommended indications; some even had low blood pressure. As most stroke patients are managed in general medical wards rather than stroke units, a greater awareness of these important aspects of blood pressure evaluation and therapy are needed among medical and nursing staff.
急性卒中患者高血压管理不当会对预后产生不利影响。我们对一家没有卒中单元的区级综合医院的40例患者在卒中后第一周的血压评估和降压治疗情况进行了检查。在最初的24小时内，血压记录的中位频率为3次（范围为1 - 12次）。第1天之后，11例患者（28%）连续1天或2天没有血压读数。没有任何患者记录测量的是哪一侧手臂。22例高血压患者（55%）均未进行双侧测量以排除双臂血压差异，所有患者中只有3例（7%）进行了体位性血压测量以排除体位性低血压。14例患者（35%）在不符合推荐指征的情况下接受了降压治疗；其中一些患者甚至血压偏低。由于大多数卒中患者是在普通内科病房而非卒中单元接受治疗，因此医护人员需要进一步重视血压评估和治疗的这些重要方面。
