摘要
目的了解手术干预对急性颅内出血病人心肌损伤的影响,探讨脑心综合征的治疗方法。方法选择60例外伤性和高血压性急性颅内出血病人,分为手术治疗组和非手术治疗组。测定发病24h、3天、7天和15天血清心肌酶、肌钙蛋白Ⅰ和心电图检查并进行分析。结果急性颅内出血病人在发病后24h内血清心肌酶、肌钙蛋白Ⅰ和心电图异常发生率开始升高,3天达到高峰,以后逐渐下降;手术后7天和15天血清心肌酶和心电图异常发生率低于非手术组,但两组比较差异无统计学意义(P>0.05);而手术组与非手术组在病程不同时间点血清肌钙蛋白Ⅰ异常升高阳性率相近,对比差异无统计学意义(P>0.05)。结论急性颅内出血病人存在较为普遍的心肌损伤,主要表现为血清心肌酶、肌钙蛋白和不同类型的心电图异常,治疗后可以恢复;单凭手术治疗原发性颅内血肿不能从根本上治疗其所并发的心肌损伤,对脑心综合征的治疗应采取综合措施。
Objective To investigate the effects of operation intervention on myocardial damage in patients with acute intracranial hemorrhage,and study the method for treating the cerebrocardiac syndrome.Methods Sixty patients with hypertensivc cerebral hemorrhage and traumatic encephalopathy were divided into operation treatment group and expectant treatmen group.We determined myocardial enzymogram,Troponin Ⅰ and electrocardiogram on 24h,3,7 and 15day after onset,and analyzed their clinical signs.Results The values of myocardial enzymogram,Troponin I and electrocardiographic abnormality increased at 24h.They increased to the peak on the day 3,and then decreased.Compared to expectant treatmen group,the abnormal incidence of myocardial enzymogram and electrocardiographic abnormality in operation treatment group were lower at 7,15day respectively（P0.05）.It was similar in the positive incidence of abnormal Troponin I at different time points between two groups（P0.05）.Conclusion Myocardial damage is universal in patients with acute intracranial hemorrhage.Its main clinical manifestations are abnormal incidence of myocardial enzymogram,Troponin I and different categories electrocardiographic abnormality,but they can recover after treatment.Operation treatment cannot cure myocardial damage in patients with acute intracranial hemorrhage fundamentally.The treatment of cerebrocardiac syndrome should be combined therapy.
出处
《医学研究杂志》
2011年第1期105-109,共5页
Journal of Medical Research
基金
温州市科技计划项目(Y20080236)
关键词
急性颅内出血
心肌损伤
心肌酶谱
肌钙蛋白Ⅰ
心电图
手术治疗
Acute intracranial hemorrhage
Myocardial damage
Myocardial enzymogram
Troponin I
Electrocardiogram
Operation treatment
