血压控制与脑出血治疗和预防医学教学课件.ppt

血压控制 与 脑出血治疗和预防;Primary Intracerebral Haemorrhage;Haematoma evolution;Early haematoma expansion;Peri-haematomal oedema in ICH;Surgical treatmentSTICH trial results;Medical treatmentrFVII (NovoSeven?);Reduction of haematoma expansion;北大医院临床诊治方案;;下述步骤应该是同步进行;;根据指南控制血压。;Role of blood pressure observational studies - mortality;Onset of ICH;脑出血患者血压控制方案;Guidelines for Acute BP Management;对于脑出血早期几个小时内可以根据下述步骤：;问题;INTERACT pilot phase(Lancet Neurology 2008; 7: 391-399.);Pathophysiology; Vanguard PhaseProtocol Schema;Systolic blood pressure differences;Crude mean (SD) change in hematoma volume by group; ;Early intensive blood pressure lowering enhances hematoma resolution but does not affect perihematoma edema:;Secondary aims;;Secondary analyses: patient flow;Mean BP after randomization;Guideline;Guideline;Summary of results;Cilostazol v.s. Aspirin in Secondary Stroke Prevention;阿司匹林已经成为公认的缺血性卒中二级预防首选药物;;;积极抗血小板治疗对不稳定性心绞痛作用只有在最初的几个星期明显 (CURE);;增加ASA，并为给高危的脑血管病患者病人带来额外的临床益处;Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance(CHARISMA)氯吡格雷用于动脉粥样硬化血栓形成高危及稳定、处理和避免缺血;0 6 12 18 24 30;CHARISMA;Profess;;;;;多中心，双盲，随机，双模拟，阿司匹林对照;入组标准;研究设计;设计流程;;终结分析;脑出血患者;症状性脑出血加无症状性核磁显示血肿;No. 136;Microbleeding found in 39%;微出血发生的危险因素;二、一年后脑微出血的动态变化及影响因素;New lesions found in Second MRI;结论;谢谢！