摘要
目的 分析硝苯地平联合甘露醇治疗对高血压脑出血(HIH)患者神经功能、血流动力学及预后评分的影响。方法 我院收治的91例HIH患者,根据治疗方式不同分为研究组47例和对照组44例。对照组给予甘露醇治疗,研究组在此基础上增加硝苯地平治疗,两组均持续治疗3个月。对比两组临床疗效、安全性、血肿体积和水肿面积、神经功能、认知功能[分别采用中国脑卒中临床神经功能缺损程度评分量表(CSS)和蒙特利尔认知评估量表(MoCA)评估]、生活能力、生活质量[以改良Rankin评分表、日常生活活动能力量表(Barthal)评估]及血流动力学指标变化情况。结果 研究组临床总有效率高于对照组(P<0.05);与对照组比较,治疗后研究组血肿体积和水肿面积均更小,CSS量表、Rankin量表评分更低,MoCA量表、BI评分更高(P<0.05);研究组血流速度高于对照组,外周阻力和临界压力低于对照组(P<0.05);两组患侧血流量比较差异无统计学意义(P>0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 硝苯地平联合甘露醇疗效显著,可改善高血压脑出血患者神经功能、血流动力学及日常生活能力,安全性高,值得推广。
Objective To analyze the effect of nifedipine combined with mannitol on the neurological function, hemodynamics and prognosis score of patients with hypertensive intracerbral hemorrhage(HIH).Methods Clinical data of 91 HIH patients admitted to our hospital from January 2019 to January 2020 were retrospectively analyzed. The patients were divided into a study group(n=47) and a control group(n=44) according to differences in treatment methods. The control group was treated with mannitol, and patients in the study group were supplemented with nifedipine.The clinical efficacy, safety, hematoma volume, edema area, neurological function, and cognitive functionassessed by the Chinese Stroke Clinical Neurological Impairment Degree Scale(CSS) and Montreal Cognitive Assessment Scale(MoCA), living ability, andquality of lifeassessed by the modified Rankin Scale(mRs) and Barthal index(BI), and changes in hemodynamic indicators were compared between the two groups.Results The total clinical effective rate of the study group was higher than that of the control group(P < 0.05). Compared with the control group, the hematoma volume and edema area in the study group were smaller, scores of CSS and mRs were lower, and MoCA scale and BI scores were higher after treatment(P<0.05). After treatment, the average blood flow velocity of the study group was higher than that of the control group, and the peripheral resistance and critical pressure were lower than those of the control group(P<0.05). There was no statistical significance in the average blood flow of the affected side between the two groups(P>0.05), and there was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Nifedipine combined with mannitol has a significant curative effect. They can improve the neurological function, hemodynamics, and ability of daily living in patients with hypertensive cerebral hemorrhage. It is safe and worthy of promotion.
作者
刘影
孙英
郝春霞
陶绪
LIU Ying;SUN Ying;HAO Chun-xia;TAO Xu(Liaoning Provincial People′s Hospital,Shenyang 110016,China)
出处
《实用医院临床杂志》
2022年第5期32-35,共4页
Practical Journal of Clinical Medicine
基金
辽宁省自然科学基金资助项目(编号:2019-ZD-0435)。
关键词
硝苯地平
甘露醇
高血压脑出血
神经功能
血流动力学
预后评分
Nifedipine
Mannitol
Hypertensive cerebral hemorrhage
Neural function
hemodynamics
Prognosis score
