目的观察复方麝香注射液联合尼莫地平治疗微创清除术后高血压性脑出血患者的临床疗效,探讨其临床应用价值。方法选取2018年5月至2019年5月本院收治的96例高血压脑出血患者,随机分为观察组和对照组,每组48例。对照组在基础治疗及护理的...目的观察复方麝香注射液联合尼莫地平治疗微创清除术后高血压性脑出血患者的临床疗效,探讨其临床应用价值。方法选取2018年5月至2019年5月本院收治的96例高血压脑出血患者,随机分为观察组和对照组,每组48例。对照组在基础治疗及护理的基础上给予尼莫地平注射液14d,后改用尼莫地平片继续服用14d;观察组在对照组的基础上加用复方麝香注射液静脉滴注28d。观察两组患者治疗前后的血肿量、水肿量、神经功能缺损程度[美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评定]、血清学相关指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-a(tumor necrosis factor-a,TNF-a)、基质金属蛋白酶-9(matrix metalloprotein-9, MMP-9)],以及治疗后临床疗效。结果(1)治疗后,两组患者的血肿量、水肿量均较本组治疗前减少,NIHSS评分均较本组治疗前降低,差异均有统计学意义(P<0.05),且观察组低于对照组(P<0.05);(2)治疗后,两组患者的血清IL-6、TNF-a、MMP-9均较本组治疗前下降(P<0.05),且观察组低于对照组(P<0.05);(3)治疗后观察组患者的总有效率为95.83%,高于对照组的81.25%(P<0.05)。结论采用复方麝香注射液联合尼莫地平治疗微创清除术后高血压性脑出血患者,可促进患者颅内血肿吸收,改善神经功能缺损,疗效显著,值得临床推广。展开更多
Objective To explore predictors of the 6-month clinical outcome ofthalamic hemorrhage, and evaluate if minimally invasive thalamic hematoma drainage （THD） could improve its prognosis. Methods A total of 54 patients ...Objective To explore predictors of the 6-month clinical outcome ofthalamic hemorrhage, and evaluate if minimally invasive thalamic hematoma drainage （THD） could improve its prognosis. Methods A total of 54 patients with spontaneous thalamic hemorrhage were evaluated retrospectively. Clinical data, including demographics, stroke risk factors, neuroimaging variables, Glasgow Coma Score （GCS） on admission, surgical strategy, and outcome, were collected. Clinical outcome was assessed using a modified Rankin Scale, six months after onset. Univariate analysis and multivariate logistic regression analysis were performed to determine predictors of a poor outcome. Results Conservative treatnaent was performed for five patients （9.3%）, external ventricular drainage （EVD） for 20 patients （37.0%）, THD for four patients （7.4%）, and EVD combined with THD for 25 patients （46.3%）. At six months after onset, 21 （38.9%） patients achieved a favorable outcome, while 33 （61.1%） had a poor outcome. In the univariate analysis, predictors of poor 6-month outcome were lower GCS on admis- sion （P = 0.001）, larger hematoma volume （P 〈 0.001）, midline shift （P = 0.035）, acute hydrocephalus （P = 0.039）, and no THD （P = 0.037）. The independent predictors of poor outcome, according to the multivariate logistic regression analysis, were no THD and larger hematoma volume. Conclusions Minimally invasive THD, which removes most of the hematoma within a few days, with limited damage to perihematomal brain tissue, improved the 6-month outcome of thalamic hemorrhage. Thus, THD can be widely applied to treat patients with thalamic hemorrhage.展开更多
目的探讨脑血疏口服液联合甘油果糖治疗脑出血的临床疗效。方法选取2017年2月—2018年1月在洛阳市第一人民医院进行治疗的76例脑出血患者为研究对象,根据用药的差别分为对照组和治疗组,每组各38例。对照组静脉滴注甘油果糖氯化钠注射液5...目的探讨脑血疏口服液联合甘油果糖治疗脑出血的临床疗效。方法选取2017年2月—2018年1月在洛阳市第一人民医院进行治疗的76例脑出血患者为研究对象,根据用药的差别分为对照组和治疗组,每组各38例。对照组静脉滴注甘油果糖氯化钠注射液500 m L/次,每次1~1.5 h,2次/d;治疗组在对照组治疗基础上口服脑血疏口服液,10 m L/次,3次/d。两组均经过4周治疗后进行效果比较。观察两组的临床疗效,比较两组治疗前后NIHSS评分、血肿量、周围水肿量、相关临床指标、脑灌注参数、血清学指标的变化情况。结果治疗后,对照组和治疗组的总有效率分别为81.58%、97.37%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分、血肿量、周围水肿量、平均通过时间(MTT)较治疗前均明显降低,脑血流量(rCBF)、相对脑血容量(rCBV)显著升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组NIHSS评分、血肿量、周围水肿量、MTT均明显小于对照组,rCBF、rCBV显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、白细胞介素-1β(IL-1β)水平均降低,而胰岛素样生长因子-1(IGF-1)水平均增高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,hs-CRP、MMP-9、IL-1β水平低于对照组,IGF-1水平高于对照组,两组比较差异具有统计学意义(P<0.05)。结论脑血疏口服液联合甘油果糖治疗脑出血具有较好的临床疗效,可有效改善患者神经功能,有利于减轻血肿周围组织低灌注损伤,促进血肿吸收,改善机体炎症反应,具有一定的临床推广应用价值。展开更多
文摘目的观察复方麝香注射液联合尼莫地平治疗微创清除术后高血压性脑出血患者的临床疗效,探讨其临床应用价值。方法选取2018年5月至2019年5月本院收治的96例高血压脑出血患者,随机分为观察组和对照组,每组48例。对照组在基础治疗及护理的基础上给予尼莫地平注射液14d,后改用尼莫地平片继续服用14d;观察组在对照组的基础上加用复方麝香注射液静脉滴注28d。观察两组患者治疗前后的血肿量、水肿量、神经功能缺损程度[美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评定]、血清学相关指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-a(tumor necrosis factor-a,TNF-a)、基质金属蛋白酶-9(matrix metalloprotein-9, MMP-9)],以及治疗后临床疗效。结果(1)治疗后,两组患者的血肿量、水肿量均较本组治疗前减少,NIHSS评分均较本组治疗前降低,差异均有统计学意义(P<0.05),且观察组低于对照组(P<0.05);(2)治疗后,两组患者的血清IL-6、TNF-a、MMP-9均较本组治疗前下降(P<0.05),且观察组低于对照组(P<0.05);(3)治疗后观察组患者的总有效率为95.83%,高于对照组的81.25%(P<0.05)。结论采用复方麝香注射液联合尼莫地平治疗微创清除术后高血压性脑出血患者,可促进患者颅内血肿吸收,改善神经功能缺损,疗效显著,值得临床推广。
基金This study was supported by National Natural Science Foundation of China （81501054）, and Kejihuimin Project of Shandong Province （2014kjhm0101）.
文摘Objective To explore predictors of the 6-month clinical outcome ofthalamic hemorrhage, and evaluate if minimally invasive thalamic hematoma drainage （THD） could improve its prognosis. Methods A total of 54 patients with spontaneous thalamic hemorrhage were evaluated retrospectively. Clinical data, including demographics, stroke risk factors, neuroimaging variables, Glasgow Coma Score （GCS） on admission, surgical strategy, and outcome, were collected. Clinical outcome was assessed using a modified Rankin Scale, six months after onset. Univariate analysis and multivariate logistic regression analysis were performed to determine predictors of a poor outcome. Results Conservative treatnaent was performed for five patients （9.3%）, external ventricular drainage （EVD） for 20 patients （37.0%）, THD for four patients （7.4%）, and EVD combined with THD for 25 patients （46.3%）. At six months after onset, 21 （38.9%） patients achieved a favorable outcome, while 33 （61.1%） had a poor outcome. In the univariate analysis, predictors of poor 6-month outcome were lower GCS on admis- sion （P = 0.001）, larger hematoma volume （P 〈 0.001）, midline shift （P = 0.035）, acute hydrocephalus （P = 0.039）, and no THD （P = 0.037）. The independent predictors of poor outcome, according to the multivariate logistic regression analysis, were no THD and larger hematoma volume. Conclusions Minimally invasive THD, which removes most of the hematoma within a few days, with limited damage to perihematomal brain tissue, improved the 6-month outcome of thalamic hemorrhage. Thus, THD can be widely applied to treat patients with thalamic hemorrhage.
文摘目的探讨脑血疏口服液联合甘油果糖治疗脑出血的临床疗效。方法选取2017年2月—2018年1月在洛阳市第一人民医院进行治疗的76例脑出血患者为研究对象,根据用药的差别分为对照组和治疗组,每组各38例。对照组静脉滴注甘油果糖氯化钠注射液500 m L/次,每次1~1.5 h,2次/d;治疗组在对照组治疗基础上口服脑血疏口服液,10 m L/次,3次/d。两组均经过4周治疗后进行效果比较。观察两组的临床疗效,比较两组治疗前后NIHSS评分、血肿量、周围水肿量、相关临床指标、脑灌注参数、血清学指标的变化情况。结果治疗后,对照组和治疗组的总有效率分别为81.58%、97.37%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分、血肿量、周围水肿量、平均通过时间(MTT)较治疗前均明显降低,脑血流量(rCBF)、相对脑血容量(rCBV)显著升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组NIHSS评分、血肿量、周围水肿量、MTT均明显小于对照组,rCBF、rCBV显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、白细胞介素-1β(IL-1β)水平均降低,而胰岛素样生长因子-1(IGF-1)水平均增高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,hs-CRP、MMP-9、IL-1β水平低于对照组,IGF-1水平高于对照组,两组比较差异具有统计学意义(P<0.05)。结论脑血疏口服液联合甘油果糖治疗脑出血具有较好的临床疗效,可有效改善患者神经功能,有利于减轻血肿周围组织低灌注损伤,促进血肿吸收,改善机体炎症反应,具有一定的临床推广应用价值。
