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目的比较纳络酮血肿腔内注射与静脉注射对高血压脑出血的疗效。方法40例高血压脑出血患者随机分为A、B两组。两组均采取锥颅血肿穿刺置管抽吸和脑室外引流治疗。A组血肿腔内局部注射纳络酮,B组静脉滴注纳络酮。比较两组患者治疗前后颅内压、GCS评分、脑脊液内皮素-1(ET-1)水平。对患者进行三月以上的随访。结果40例脑出血患者发病后48hET-1平均水平明显高于非脑出血患者。A组发病后第3天、第7天ET-1峰值较B组明显低(P<0.01);A组术后颅内压较B组降低更明显(P<0.01);连续GCS评分较B组明显高(P<0.01),平均清醒天数缩短;A组治疗有效率明显高于B组(P<0.05)。结论纳络酮血肿腔内注射较静脉注射可明显提高脑出血患者疗效,改善预后。
Objective To compare the efficacy of intra-naloxone hematoma injection and intravenous injection on hypertensive intracerebral hemorrhage. Methods 40 patients with hypertensive intracerebral hemorrhage were randomly divided into A and B groups. Both groups were treated with pyramidal hematoma aspiration catheter and ventricle drainage. In group A, naloxone was injected locally into the hematoma, while group B was infused with naloxone intravenously. The intracranial pressure, GCS score and the level of endothelin-1 (ET-1) in CSF were compared between the two groups before and after treatment. Patients were followed for more than three months. Results The average level of ET-1 at 48 hours after onset of cerebral hemorrhage in 40 patients was significantly higher than that in non-ICH patients. The peak value of ET-1 in group A was significantly lower than that in group B on the 3rd day and the 7th day (P <0.01); the intracranial pressure in group A was lower than that in group B (P <0.01) (P <0.01), and the average number of awake days shortened. The effective rate of treatment in group A was significantly higher than that in group B (P <0.05). Conclusion Intracavity injection of naloxone intracerebroventricular injection can significantly improve the efficacy of cerebral hemorrhage patients and improve prognosis.