39岁女性,患高血压:病例报告

Neema Putri Prameswari, Vioren, Anisa Ramadhanti, Zamzanariah Ibrahim
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摘要

高血压性脑病是一种由血压突然升高引起的急性可逆性综合征,因此超出了大脑自动调节的范围。撰写这篇科学论文的目的是介绍高血压脑病的临床表现,并报道高血压脑病患者在综合治疗后的良好临床结果。本文是对现实生活中高血压性脑病症状的实证研究。女,39岁,主诉突发癫痫,癫痫发作前她感到全身无搏动性头痛。血压升高200/130毫米汞柱。神经眼科检查显示右眼无光感,其他神经功能未见异常。住院期间给予降压药氨氯地平和拉米普利,并给予DASH饮食。患者病情好转,治疗第5天出院。高血压脑病的诊断是建立在高血压加上神经系统症状的基础上,并排除了其他可能引起类似症状的条件。在目标血压为150/100 mmHg (MAP的20%)时谨慎使用抗高血压药物。DASH饮食的应用由于限制了食物中钠的摄入,有降低血压的效果。高血压脑病的治疗包括降低血压,但不建议过于激进,因为这会导致局部缺血。预防措施非常重要,需要研究高血压脑病的预测因素和高危人群的高警觉性。
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Wanita Usia 39 Tahun dengan Ensefalopati Hipertensi: Laporan Kasus
Hypertensive encephalopathy is an acute reversible syndrome caused by a sudden increase of blood pressure so crosses the limits of brain auto-regulation. The objective of writing this scientific paper was to present clinical manifestations of hypertensive encephalopathy and report the favorable clinical outcomes in hypertensive encephalopathy patients with comprehensive therapy. This paper is an empirical case study investigates the symptoms of Hypertensive Encephalopathy in real life. Female, 39 years old complaints of sudden seizures, before the seizure she felt of non-throbbing headache all over her head. There was an increase in blood pressure of 200/130 mmHg. On neurologic-ophthalmologic examination, her right eye had no light perception (NLP), while on other neurological functions there were no abnormalities. She was hospitalized and treated with antihypertensive drugs, that are Amlodipine and Lamipril, during inpatient the DASH diet was given. The patient showed improvement, then was discharged on the 5th day of treatment. Diagnosis of hypertensive encephalopathy was made in this patient built upon high blood pressure plus neurologic symptoms and the exclusion of other conditions that could cause similar symptoms. Antihypertensives were used carefully at a target blood pressure of 150/100 mmHg (20% of MAP). Application of DASH diet has an effect for lowering blood pressure due to the restriction of sodium intake from food. Management of hypertensive encephalopathy includes lowering blood pressure but it’s not recommended aggressively because it can cause ischemia. Preventive measures are very important, research is needed on predictive factors for hypertension encephalopathy and a high level of alertness in risk groups.
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