Hypertension, a chronic disease, may be very common in people's daily lives, mainly because the current population is prone to such diseases. However, it should be noted that although it is a chronic disease, its harm is still very significant, mainly due to its complications. Below, the editor will take you to pay attention to a question: What are the principles for handling hypertensive crises?
1. Blood pressure should be lowered quickly, safely, and effectively. As for the degree of blood pressure drop, it varies from person to person. If the kidney function is normal and there is no cerebrovascular disease or coronary heart disease, the blood pressure can be reduced to normal. But if the patient is over 60 years old, has coronary heart disease, cerebrovascular disease, or renal insufficiency, and the blood pressure drops too quickly or violently, it can lead to insufficient blood supply to the coronary or cerebral arteries or oliguria. The safe blood pressure level is 21.3-24.0/13.3-14.7 kPa (160-180/100-110 mmHg).
2. Choose medication according to the condition and achieve the goal of lowering blood pressure at an appropriate speed. Sodium nitroprusside takes effect in seconds, metronidazole takes effect in minutes, and levodopa, levodopa, and levodopa take effect in hours. The action time, advantages, and disadvantages of commonly used antihypertensive drugs in hypertensive crisis are shown in Table 18-1. Among them, sodium nitroprusside is the most ideal. When sodium nitroprusside is used unconditionally, intravenous injection of low pressure azole can be used. If the condition is not very urgent, intramuscular injection of reserpine can be used.
3. It is advisable to monitor patients in CCU or ICU for close monitoring and to avoid dehydration or excessive fluid replacement. The former can cause pre renal azotemia, while the latter can further increase blood pressure and cause heart failure. 4. Adding dehydrating agents such as mannitol and furosemide for the prevention and treatment of cerebral edema, hypertension, and encephalopathy; For patients with cerebral edema and convulsions, methods such as intramuscular injection of phenobarbital sodium, diazepam, and chloral hydrate enema can be used to calm the nerves.
5. When treating heart failure with acute left heart failure, it is recommended to use sodium nitroprusside for cardiac enhancement, diuresis, and vasodilation.
6. Patients with combined azotemia should undergo hemodialysis treatment.
7. When pheochromocytoma is combined with hypertensive crisis, the tumor secretes a large amount of catecholamines, causing a sharp increase in blood pressure. Before surgery, the alpha receptor blocker phentolamine should be used to lower blood pressure.
8. Early restriction of activity and salt intake is sufficient to increase blood flow to the uterus, placenta, and kidneys when combined with gestational hypertension. If proteinuria worsens, blood pressure rises, vision declines, urine output decreases, weight gain or headaches occur, hospitalization should be sought. Especially headaches should be taken seriously, indicating the possibility of eclampsia. Pregnancy should be terminated before eclampsia occurs.
The above is the relevant information compiled by the editor on the principles of handling hypertension crisis. For some principles of treating diseases, I think that apart from professional doctors, most people still know very little about them. Doctors also treat diseases based on certain principles combined with their own abilities, so doctors have their own strengths and weaknesses. I wish everyone good health!
