目的 探讨吡拉西坦联合七叶皂苷钠治疗脑出血的临床疗效。方法 选取2014年7月-2016年7月在盐亭县人民医院进行治疗的脑出血患者62例，依据治疗方法的不同分为对照组（31例）和治疗组（31例）。对照组静脉滴注注射用七叶皂苷钠，10 mg加入250 mL生理盐水，2次/d。治疗组在对照组的基础上静脉滴注吡拉西坦注射液，8 g加入250 mL生理盐水，1次/d。两组患者均治疗2周。评价两组患者临床疗效，同时比较治疗前后两组患者神经功能缺损程度评分（NIHSS）、蒙特利尔认知评估量表（MoCA）、简易智力状态检查量表（MMSE）和日常生活能力量表（ADL）以及脑水肿、脑血肿体积和血清学指标变化。结果 治疗后，对照组和治疗组总有效率分别为80.65%、96.77%，两组比较差异具有统计学意义（P<0.05）。治疗后，NIHSS显著降低，MoCA、MMSE和ADL评分均显著升高，同组比较差异具有统计学意义（P<0.05）；且治疗组患者上述4项评分均明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组脑水肿和脑血肿体积均显著减小（P<0.05）；且治疗组患者脑水肿和脑血肿体积显著小于对照组（P<0.05）。治疗后，两组患者血清NSE、MCP-1、水平均降低，但BDNF水平升高（P<0.05）；且治疗组的血清学指标改善优于对照组（P<0.05）。结论 吡拉西坦联合七叶皂苷钠治疗脑出血可有效降低脑水肿和脑血肿体积，有利于神经功能和认知功能的改善，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of piracetam combined with sodium aescinate in treatment of cerebral hemorrhage. Methods Patients (62 cases) with cerebral hemorrhage in Yanting People's Hospital from July 2014 to July 2016 were divided into control (31 cases) and treatment (31 cases) groups based on different treatments. Patients in the control group were iv administered with Sodium Aescinate for injection, 10 mg added into normal saline 250 mL, twice daily. Patients in the treatment group were iv administered with Piracetam Injection on the basis of the control group, 8 g added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, clinical efficacy was evaluated, and the change of NIHSS, MoCA, MMSE, and ADL scores, and cerebral edema and cerebral hematoma volume, and serum indicators in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.65% and 96.77%, respectively, and there were differences between two groups (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but MoCA, MMSE, and ADL scores were significantly increased, and the difference was statistically significant in the same group (P<0.05). And these scores 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 cerebral edema and cerebral hematoma volume in two groups was significantly decreased (P<0.05). And the cerebral edema and cerebral hematoma volume in the treatment group was significantly smaller than that in the control group (P<0.05). After treatment, the NSE and MCP-1 levels in two groups were significantly decreased, but BDNF were significantly increased (P<0.05). And these serum indicators in treatment group were significantly better than those in the control group (P<0.05). Conclusion Piracetam combined with sodium aescinate can effectively reduce the cerebral edema and cerebral hematoma volume in treatment of cerebral hemorrhage, and is conducive to the improvement of neurological cognitive function, which has a certain clinical application value.