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[摘要]
目的 探討醒腦靜注射液聯(lián)合注射用尿激酶治療高血壓腦出血的臨床療效。方法 選取2015年1月-2016年6月武警后勤學(xué)院附屬醫(yī)院收治的高血壓腦出血患者84例為研究對(duì)象,采用Excel表法隨機(jī)分為對(duì)照組和治療組,每組各42例。兩組采用微創(chuàng)引流穿刺術(shù),向血腫腔內(nèi)注入注射用尿激酶,10萬(wàn)單位加入到生理鹽水5 mL中,保留2~3 h后引流。待血腫清除后拔管(5 d左右)。術(shù)后對(duì)照組靜脈滴注5%葡萄糖注射液250 mL,1次/d;治療組在對(duì)照組的基礎(chǔ)上術(shù)后靜脈滴注醒腦靜注射液,20 mL加入到生理鹽水250 mL中,1次/d。兩組患者均持續(xù)治療4周。觀(guān)察兩組的臨床療效,比較兩組的美國(guó)國(guó)立衛(wèi)生研究院腦卒中量表(NIHSS)評(píng)分和血清學(xué)指標(biāo)。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為81.0%、92.9%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組NIHSS評(píng)分均顯著下降,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組NIHSS評(píng)分明顯低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組血清C-反應(yīng)蛋白(CRP)、腫瘤壞死因子-α(TNF-α)和巨噬細(xì)胞轉(zhuǎn)移抑制因子(MIF)水平均顯著下降,胰島素樣生長(zhǎng)因子-1(IGF-1)水平顯著升高,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些血清學(xué)指標(biāo)的改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 醒腦靜注射液聯(lián)合注射用尿激酶治療高血壓腦出血具有較好的療效,能改善神經(jīng)功能,降低血清炎癥水平,具有一定的臨床推廣應(yīng)用價(jià)值。
[Key word]
[Abstract]
Objective To investigate the clinical effect of Xingnaojing Injection combined with Urokinase for injection in treatment of hypertensive cerebral hemorrhage. Methods Patients (84 cases) with hypertensive cerebral hemorrhage in Affiliated Hospital of Armed Police Logistics College from January 2015 to June 2016 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in two groups were treated with minimally invasive puncture, and injected Urokinase for injection into the intracavity of hematoma, added into 100 000 unit normal saline 5 mL, open drainage after 2-3 h retention, extubation after removal of hematoma (about 5 d). After surgery, patients in the control group were iv administered with 5% glucose solution 250 mL, once daily. Patients in the treatment group were po administered with Xingnaojing Injection on the basis of the control group, 20 mL added into normal saline 250 mL, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and NIHSS scores and serological index in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.0% and 92.9%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the NIHSS score in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP, TNF-α, and MIF in two groups were significantly decreased, but the levels of IGF-1 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serological indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Xingnaojing Injection combined with Urokinase for injection has clinical curative effect in treatment of hypertensive cerebral hemorrhage, can improve neurological function, and reduce serum inflammatory level, which has a certain clinical application value.
[中圖分類(lèi)號(hào)]
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