頁籤選單縮合
題名 | 重症患者高血壓急症之治療=Management of Hypertensive Emergency on the Critically Ⅲ Patients |
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作 者 | 林世崇; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 1:1 1999.10[民88.10] |
頁次 | 頁71-81 |
分類號 | 415.382 |
關鍵詞 | 高血壓急症; 高血壓危象; 標的器官受損; 降壓藥物; 重症加護醫療; 腦血管疾病; Hypertensive emergency; Hypertensive crisis; Target organ damage; Antihypertensive drugs; Critical care medicine; Cerebravascular disease; |
語文 | 中文(Chinese) |
中文摘要 | 加護病人經常會出現高血壓急症。有些是危及生命的高血壓危象重症,有些只是暫時現象。不同疾病及狀況下,均可能發生高血壓急症。除了重症疾病及其併發症可能引發突然嚴重血壓升高之外,外在因素包括病人與呼吸器無法配合,手術後疼痛,體溫變化。臨床評估病人時,特別注意是否有標的器官受損,考慮病人是否有次發性高血壓的可能。治療過程需要隨時監測其血壓變化。若要使用降壓藥物治療時,必須謹慎,以免突破腦,心臟,及腎臟的血管區之自動調節的功能,反而造成組織血流灌注不足。治療藥物包括靜脈注射之血管擴張劑,及腎上腺素抑制劑。不同的臨床疾病各有其適合之降壓藥物。心臟功能異常時,選用可以減少前負荷或後負荷之降壓藥物。心肌缺氧或梗塞時,應避免使用會引起反射性心跳加快的藥物。腦血管病變時,應避免使用會使腦壓增加之藥物。降血壓的目標值,以下降20-25%為目標。避免使用不適合之降壓藥物,以免使原來病況更趨嚴重。 |
英文摘要 | The critical care patients are often encountered with hypertensive emergencies under different situation. In addition to medical diseases, the secondary causes to induce sudden rise of blood pressure are ventilatory problems, and postoperative hypertension. To approach the critical hypertensive emergencies, target organ perfusion should be carefully monitored and requires expeditious blood pressure reduction to avoid life-threatening consequences. The drugs for treating hypertensive emergencies include vasodilators, adrenergic receptor blockers and angiotensin enzyme inhibitors. The potential hazards of over treating hypertension, which induce hypotension and organ hypoperfusion. In some situations, the sudden rise of blood pressure is only temporary and can be recovered spontaneously. The choice of the appropriated drugs to reduce the hypertensive emergencies depends on the underlying clinical entities. Not only to obtain the target blood pressure, but also to keep adequate organ perfusion and avoid subsequent systemic or cerebral damage by breaking through the autoregulation are the important issues in the critically ill patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。