Tăng huyết áp điều trị: nguyên tắc và phương pháp

Springer Science and Business Media LLC - Tập 27 - Trang 227-235 - 2004
David J. Powner1,2, Joseph M. Darby3, John W. Crommett1, Robert L. Levine1,4
1Department of Neurosurgery, Vivian L. Smith Center of Neurologic Research, University of Texas Health Science Center, Houston, USA
2Department of Medicine, Vivian L. Smith Center of Neurologic Research, University of Texas Health Science Center, Houston, USA
3Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
4Department of Emergency Medicine, Vivian L. Smith Center of Neurologic Research, University of Texas Health Science Center, Houston, USA

Tóm tắt

Các khía cạnh sinh lý tim mạch quan trọng cho việc thực hiện và điều chỉnh an toàn cũng như hiệu quả liệu pháp điều trị tăng huyết áp ở những bệnh nhân phẫu thuật thần kinh mắc các bệnh lý hoặc chấn thương thần kinh/thần kinh lành mạnh đã được xem xét. Tăng huyết áp điều trị có thể là một phương pháp điều trị thích hợp cho một số tình trạng thần kinh hoặc phẫu thuật thần kinh, ví dụ như co thắt mạch hoặc hỗ trợ áp lực tưới máu não. Việc khởi đầu và duy trì tình trạng tăng huyết áp cần được thực hiện một cách an toàn để tránh các biến chứng và/hoặc tác dụng phụ không mong muốn. Việc đo đạc chính xác áp lực động mạch và áp lực mạch trung tâm, các hạn chế của các phương pháp đó, và các ước tính thay thế của thể tích nội mạch cũng được xem xét. Liệu pháp tăng huyết áp được thực hiện bằng cách thay đổi lưu lượng tim và kháng lực mạch hệ thống, các yếu tố sinh lý chính của huyết áp. Các mục tiêu của liệu pháp tăng huyết áp có thể đạt được thông qua việc đánh giá và điều chỉnh hợp lý bốn thành phần của lưu lượng tim: áp lực trước tâm thu, áp lực sau tâm thu, nhịp tim và khả năng co bóp. Việc đo hoặc tính toán các ước tính của các thông số này là rất quan trọng trong việc chọn lựa thuốc phù hợp hoặc bổ sung dịch truyền.

Từ khóa

#tăng huyết áp #sinh lý tim mạch #phẫu thuật thần kinh #điều trị tăng huyết áp #áp lực tưới máu não

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