论文部分内容阅读
【目的】研究乌司他丁联合醒脑静对急性脑出血患者的脑保护作用。【方法】将108例急性脑出血患者随机分为治疗组56例和对照组52例。所有患者均给予西医常规处理,包括:减轻脑水肿、调整血压、维持电解质平衡、抗感染、预防癫痫等。在此基础上,对照组单纯给予乌司他丁治疗,治疗组给予乌司他丁联合醒脑静治疗。2组均以14 d为1个疗程,并于2个月后随访。分别观察2组第3、7、14天颅内血肿清除情况及用药1个疗程后脑水肿吸收情况,比较2组14 d、30 d神经功能评分(NDS),并评估疗效。【结果】(1)治疗后,2组血肿面积均显著缩小(P<0.05);治疗3 d后,治疗组的血肿面积虽小于对照组,但差异无统计学意义(P>0.05);治疗7 d、14 d后,治疗组的血肿面积均显著小于对照组(P<0.05)。(2)治疗14 d后,治疗组脑水肿吸收的总有效率为89.3%,对照组为65.4%;治疗组脑水肿吸收情况明显好于对照组(P<0.05)。(3)治疗后,治疗组神经功能缺失程度评分(NDS)显著低于对照组,总有效率(89.3%)显著高于对照组(71.2%)(均P<0.05)。(4)不良反应及临床结局:治疗组3例出现轻度转氨酶升高,对照组8例出现转氨酶升高,停药后转氨酶逐渐降为正常;治疗组2例治疗过程中再出血行急诊手术治疗后剔除,3例病情恶化死亡,对照组7例病情恶化放弃治疗,随访时已死亡。【结论】乌司他丁联合醒脑静对急性脑出血患者具有良好的脑保护作用。
【Objective】 To investigate the protective effect of ulinastatin combined with xingnaojing on brain in patients with acute cerebral hemorrhage. 【Methods】 108 patients with acute cerebral hemorrhage were randomly divided into treatment group 56 cases and control group 52 cases. All patients were given Western conventional treatment, including: reduce cerebral edema, blood pressure, maintaining electrolyte balance, anti-infection, prevention of epilepsy and so on. On this basis, the control group was given ulinastatin alone and the treatment group was given ulinastatin combined with xingnaojing. Both groups took 14 days for a course of treatment and were followed up after 2 months. The clearance of intracranial hematoma on the 3rd, 7th and 14th days in each group and the absorption of cerebral edema after 1 course of treatment were observed. The neurological function scores (NDS) were compared between the two groups on the 14th and the 30th days, and the curative effect was evaluated. 【Results】 (1) After treatment, the hematoma area of both groups was significantly reduced (P <0.05); after 3 days of treatment, the hematoma area of the treatment group was smaller than that of the control group, but the difference was not statistically significant (P> 0.05) After 7 and 14 days, the area of hematoma in the treatment group was significantly less than that in the control group (P <0.05). (2) After 14 days of treatment, the total effective rate of brain edema absorption in the treatment group was 89.3% and in the control group was 65.4%. The brain edema absorption in the treatment group was significantly better than that in the control group (P <0.05). (3) After treatment, the score of neurological deficit (NDS) in the treatment group was significantly lower than that in the control group, and the total effective rate (89.3%) was significantly higher than that in the control group (71.2%) (all P <0.05). (4) Adverse reactions and clinical outcomes: In the treatment group, mild aminotransferase increased in 3 patients, elevated aminotransferase in 8 patients in the control group, and gradually decreased to normal after stopping the drug treatment. In the treatment group, 2 patients were re-bleeding during the emergency procedure After treatment, 3 cases were exacerbated, while 7 cases in control group were given up for treatment. The patients died at follow-up. 【Conclusion】 Ulinastatin combined with Xingnaojing has a good brain protective effect on patients with acute cerebral hemorrhage.