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目的观察甘露醇联合神经生长因子(NGF)用于改善高血压脑出血患者预后的效果。方法对158例高血压基底节脑出血患者随机分为对照组、治疗组和特殊治疗组。对照组给予常规神经内科治疗,治疗组在对照组基础上给予神经生长因子12μg肌注,每天一次,连续15 d;特殊治疗组在肌注神经生长因子12μg后20 min即快速静注20%甘露醇250 ml,连续15 d。以三组患者6月后ADL评分为预后观察指标对三组患者恢复情况作出对比研究分析。结果三组病例均获随访,ADL评分与性别、年龄、血肿量、入院时GCS评分差异无统计学意义(P>0.05);与治疗方法差异有统计学意义(P=0.029)。已ADL分级作为观察指标,特殊治疗组的总有效率(92.5%)优于治疗组(86.8%),治疗组的总有效率(86.8%)优于对照组(80.8%),通过秩和检验3组患者ADL评分的比较,差异有统计学意义(χ2=6.538,P<0.05)。结论甘露醇开放血脑屏障后应用神经生长因子(NGF)对改善高血压脑出血患者预后能起到较为明确的作用。
Objective To observe the effect of mannitol and nerve growth factor (NGF) on the prognosis of patients with hypertensive intracerebral hemorrhage. Methods 158 patients with hypertensive basal ganglia intracerebral hemorrhage were randomly divided into control group, treatment group and special treatment group. The control group was given routine neurological treatment. The treatment group was given intramuscular injection of 12μg of nerve growth factor once a day for 15 days on the basis of the control group. In the special treatment group, 20% of the mannitol was intravenously injected 20 minutes after intramuscular injection of nerve growth factor 12μg 250 ml of alcohol for 15 days. Three groups of patients after 6 months ADL score for the prognosis of indicators of the recovery of the three groups were compared and analyzed. Results All three groups of patients were followed up. There was no significant difference in ADL score, sex, age, hematoma volume and GCS score at admission (P> 0.05). The difference was statistically significant (P = 0.029). The total effective rate of the special treatment group (92.5%) was higher than that of the treatment group (86.8%), the total effective rate of the treatment group (86.8%) was superior to that of the control group (80.8%), There was significant difference in ADL score between the three groups (χ2 = 6.538, P <0.05). Conclusion The application of nerve growth factor (NGF) after mannitol opens blood-brain barrier can play a more clear role in improving the prognosis of patients with hypertensive intracerebral hemorrhage.