2009-7-1 21:20
cutepeggy
血壓飆高 需不需要掛急診?
[align=center][color=Red][size=6][b]血壓飆高 需不需要掛急診?[/b][/size][/color]
[img]http://l.yimg.com/f/i/tw/news/newspartner2007/libertytimes_logo.jpg[/img]更新日期:2009/06/28 04:09文／吳賢寧[/align]
[color=RoyalBlue][size=4][b]高血壓，需不需要掛急診？大家應該還記得，衛生署長葉金川有一次在立法院的拉扯衝突中，收縮壓飆到160mmHg，為此趕緊掛急診住院。在那段期間，醫院急診室多了許多病人，都是在家量血壓超過160mmHg，曾有人戲稱，那是「金川症候群」。
◎血壓高要掛急診嗎？
高血壓是慢性病，依照歐洲心臟學會的標準，若每日正確測量血壓發現，平日血壓若大於135/85mmHg，就叫做高血壓了。如果每日按時服藥，時常測量，應該可以穩定控制，不該因此倉皇跑急診。
◎至於偶爾頭暈目眩血壓竄升，需不需要掛急診？血壓高到多少，需要掛急診？
一般來說，惡性高血壓才需要緊急處理，它的症狀包括胸悶、氣喘、肢體無力、水腫、意識不清，這類病人的血壓通常超過180/120mmHg。
◎什麼情形會造成惡性高血壓？
最常見的原因還是平日疏於保養，缺乏穩定控制；只有少數人是來自內分泌異常或懷孕併發症。一旦發生惡性高血壓，不只要掛急診，並且也常需進加護病房治療。
若僅僅頭暈加血壓升高，沒其它症狀，急診醫師會讓病人靜坐休息，平緩情緒後，再量量血壓，若休息充足後，血壓慢慢平穩，當然不需緊急治療。
◎血壓到底需要控制到什麼程度？
一般無症狀的病人，門診血壓最好小於140/90mmHg；若合併糖尿病，則希望血壓控制到小於130/80mmHg；至於心衰竭病患或腎病變，則可能需控制得更低。
（作者為彰化基督教醫院鹿基分院心臟血管內科主治醫師）[/b][/size][/color]
2010-8-20 22:03
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