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目的探讨早期应用尼莫地平治疗急性高血压脑出血及控制继发性再出血的临床疗效,分析可能机制。方法将符合入组标准的82例急性高血压脑出血患者随机分为2组,实验组42例,应用尼莫地平注射液微量泵静脉泵入,共7d;对照组40例,应用20%甘露醇注射液静滴,2组其余基础治疗均相同。2组均在入院时、入院后1、3、7、21d行头颅CT检查,测量血肿体积、血肿周围水肿带体积,并给予神经功能缺损评分,入院时及28d后行生活自理能力量表评分,并进行比较。结果2组在血肿体积、血肿周围水肿带体积、神经功能缺失评分、生活自理能力量表评分等方面差异均有统计学意义(P均<0.05),实验组疗效显著优于对照组。结论脑出血急性期给予尼莫地平降压止血治疗,不仅可以降低血肿扩大及再出血的发生风险,减轻血肿周围水肿带,且可以降低致残率,改善临床转归。
Objective To investigate the clinical efficacy of early application of nimodipine in the treatment of acute hypertensive intracerebral hemorrhage and control secondary hemorrhage and to analyze the possible mechanism. Methods A total of 82 patients with acute hypertensive intracerebral hemorrhage who met the inclusion criteria were randomly divided into two groups, 42 in the experimental group. Nimodipine was injected intravenously by micropumps for 7 days. In the control group, 40 cases were treated with 20% Alcohol injection intravenous infusion, the remaining two groups of basic treatment are the same. At admission, 1, 3, 7 and 21 days after admission, head CT examination was performed to measure the volume of hematoma and the volume of edema around hematoma, and neurological deficit scores were obtained. On admission and after 28 days, self-care ability scale , And compare. Results There were significant differences between the two groups in the hematoma volume, the edema volume around the hematoma, the neurological deficit score and the self-care ability scale (P <0.05). The curative effect in the experimental group was significantly better than that in the control group. Conclusion Nimodipine is given in the acute phase of cerebral hemorrhage to reduce blood pressure and hemostasis, which not only reduces the risk of hematoma expansion and rebleeding, but also reduces the edema zone around the hematoma. It can reduce the morbidity and improve the clinical outcome.