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[摘要]
目的 探讨醒脑静注射液联合注射用尿激酶治疗高血压脑出血的临床疗效。方法 选取2015年1月-2016年6月武警后勤学院附属医院收治的高血压脑出血患者84例为研究对象,采用Excel表法随机分为对照组和治疗组,每组各42例。两组采用微创引流穿刺术,向血肿腔内注入注射用尿激酶,10万单位加入到生理盐水5 mL中,保留2~3 h后引流。待血肿清除后拔管(5 d左右)。术后对照组静脉滴注5%葡萄糖注射液250 mL,1次/d;治疗组在对照组的基础上术后静脉滴注醒脑静注射液,20 mL加入到生理盐水250 mL中,1次/d。两组患者均持续治疗4周。观察两组的临床疗效,比较两组的美国国立卫生研究院脑卒中量表(NIHSS)评分和血清学指标。结果 治疗后,对照组和治疗组的总有效率分别为81.0%、92.9%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组NIHSS评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和巨噬细胞转移抑制因子(MIF)水平均显著下降,胰岛素样生长因子-1(IGF-1)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些血清学指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 醒脑静注射液联合注射用尿激酶治疗高血压脑出血具有较好的疗效,能改善神经功能,降低血清炎症水平,具有一定的临床推广应用价值。
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[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.
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