[關(guān)鍵詞]
[摘要]
目的 探討烏司他丁注射液聯(lián)合醒腦靜注射液治療急性重型高血壓腦出血的臨床療效。方法 選取2015年3月—2019年2月在南陽市中心醫(yī)院神經(jīng)外科治療的180例急性重型高血壓腦出血患者為研究對(duì)象,所有患者隨機(jī)分為對(duì)照組和治療組,每組各90例。對(duì)照組患者靜脈滴注醒腦靜注射液,20 mL/次,1次/d;治療組患者在對(duì)照組治療基礎(chǔ)上靜脈滴注烏司他丁注射液,20萬單位/次,2次/d,兩藥間隔1 h滴注。兩組患者均連續(xù)治療14 d。觀察兩組的臨床療效,比較兩組的格拉斯哥昏迷(GCS)評(píng)分、美國國立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分、Barthel指數(shù)(BI)評(píng)分、血清炎癥因子水平。結(jié)果 治療后,對(duì)照組與治療組總有效率分別為67.78%、83.33%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療3、7、14 d后,兩組患者GCS評(píng)分均較治療前升高,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療7、14 d后,治療組患者GCS評(píng)分顯著高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者NIHSS評(píng)分明顯下降,BI評(píng)分顯著升高,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),且治療組患者NHISS評(píng)分、BI評(píng)分均顯著優(yōu)于對(duì)照組,兩組比較差異均具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者血清超敏C反應(yīng)蛋白(hs-CRP)、白細(xì)胞介素-1(IL-1)、白細(xì)胞介素-8(IL-8)、腫瘤壞死因子α(TNF-α)水平均較治療前顯著降低(P<0.05),且治療組炎癥因子水平顯著低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 烏司他丁注射液聯(lián)合醒腦靜注射液治療急性重型高血壓腦出血具有較好的臨床療效,可改善臨床癥狀,增強(qiáng)炎癥反應(yīng)的抑制能力,提高生活質(zhì)量,安全性較高,具有一定的臨床推廣應(yīng)用價(jià)值。
[Key word]
[Abstract]
Objective To explore clinical efficacy of Ulinastatin Injection combined with Xingnaojing Injection in treatment of acute severe hypertensive intracerebral hemorrhage. Methods Patients (180 cases) with acute severe hypertensive intracerebral hemorrhage in Nanyang Central Hospital from March 2015 to February 2019 were randomly divided into control and treatment groups, and each group had 90 cases. Patients in the control group were iv administered with Xingnaojing Injection, 20 mL/time, once daily. Patients in the treatment group were iv administered with Ulinastatin Injection on the basis of the control group, 200 000 U/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and GCS scores, NIHSS scores, BI scores, and the serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 67.78% and 83.33%, respectively, and there was difference between two groups (P<0.05). After treatment for 3, 7, and 14 d, GCS scores in two groups were significantly increased, and the difference was statistically significant (P<0.05). After treatment for 7 and 14 d, the GCS score in the treatment group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). After treatment, NIHSS scores in two groups were significantly decreased, but BI scores in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the NIHSS score and BI score in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, IL-1, IL-8, and TNF-α in two groups were significantly decreased (P<0.05), and the serum level of inflammatory factors in the treatment group was significantly lower than that in the control group, and the difference was statistically significant in the same group (P<0.05). Conclusion Ulinastatin Injection combined with Xingnaojing Injection has clinical curative effect in treatment of acute severe hypertensive intracerebral hemorrhage, can improve the clinical symptoms, enhance the inhibition ability of inflammatory reaction, and improve the quality of life, with good safety, which has a certain clinical application value.
[中圖分類號(hào)]
R971
[基金項(xiàng)目]