伴有李琦岛征现象的基底节出血使用甘露醇联合尼莫地平内科综合治疗临床疗效观察
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摘要
目的探讨甘露醇联合尼莫地平内科综合治疗对伴有李琦岛征现象的急性基底节出血的疗效。方法抽取本院2016年4月至2017年11月收治的68例伴有李琦岛征现象的急性基底节出血患者为研究对象,根据治疗方式分为常规组、对照组和观察组。常规组采用内科保守治疗方式,对照组实施外科手术疗法,观察组给予甘露醇联合尼莫地平的内科综合治疗方案,比较不同治疗方案临床效果。结果观察组治疗总有效率为91.3%,显著优于常规组59.1%和对照组65.2%(P<0.05);观察组治疗后的颅内血肿体积显著低于常规组和对照组,观察组的预后改善显著优于其他两组(P<0.05)。结论给予伴李琦岛征现象的急性基底节出血患者甘露醇联合尼莫地平的内科综合治疗方案,疗效确切,显著减少血肿体积,且可推动预后顺利开展,值得临床推广应用。
objective To explore the curative effect of mannitol combined with nimodipine in the treatment of acute basal ganglia hemorrhage with li qi island syndrome. Methods A total of 68 cases of acute basal ganglia hemorrhage with li qi' s symptoms were selected from our hospital from April 2016 to November 2017. According to the treatment methods, the patients were divided into conventional group, control group and observation group. The conventional group was treated with conservative medical treatment, while the control group was treated with surgical treatment.The observation group was treated with a comprehensive medical treatment regimen of mannitol combined with nimodipine, and the clinical effects of different treatment regimens were compared. Results The total effective rate of treatment in the observation group was 91.3%, significantly higher than 59.1% in the conventional group and 65.2% in the control group(P<0.05). The intracranial hematoma volume of the observation group was significantly lower than that of the conventional group and the control group, and the improvement of the prognosis of the observation group was significantly better than that of the other two groups(P<0.05). Conclusion The combined treatment of mannitol with nimodipine for acute basal ganglia hemorrhage with li qi island sign is effective and can significantly reduce the size of hematoma.
objective To explore the curative effect of mannitol combined with nimodipine in the treatment of acute basal ganglia hemorrhage with li qi island syndrome. Methods A total of 68 cases of acute basal ganglia hemorrhage with li qi' s symptoms were selected from our hospital from April 2016 to November 2017. According to the treatment methods, the patients were divided into conventional group, control group and observation group. The conventional group was treated with conservative medical treatment, while the control group was treated with surgical treatment.The observation group was treated with a comprehensive medical treatment regimen of mannitol combined with nimodipine, and the clinical effects of different treatment regimens were compared. Results The total effective rate of treatment in the observation group was 91.3%, significantly higher than 59.1% in the conventional group and 65.2% in the control group(P<0.05). The intracranial hematoma volume of the observation group was significantly lower than that of the conventional group and the control group, and the improvement of the prognosis of the observation group was significantly better than that of the other two groups(P<0.05). Conclusion The combined treatment of mannitol with nimodipine for acute basal ganglia hemorrhage with li qi island sign is effective and can significantly reduce the size of hematoma.
引文
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[2]叶强敏,金涵子,黄永前,等.基底节区脑出血血肿扩大预测模型的建立及手术时机研究[J].中国医药导报,2014,11(33):54-57.
[3] Ortiz GA, Sacco RL. National Institutes of Health Stroke Scale(NIHSS)[M]//Wiley Encyclopedia of Clinical Trials. John Wiley&Sons, Inc,2014:61.
[4]蒋君.微创颅内血肿清除术治疗高血压性基底节区脑出血的疗效探讨[J].当代医学,2014,20(32):77-78.
[5] Bang OY. Intracranial Atherosclerosis:Current Understanding and Perspectives[J]. Journal of Stroke,2014,16(1):27.
[6]戴正泽,王辉军,赵应群.脑出血血肿扩大的研究进展[J].中国神经免疫学和神经病学杂志,2015,22(5):365-368.
[7]李上华,吴学永,黄雄.CTA点征与脑出血患者早期血肿扩大的关系研究[J].现代诊断与治疗,2015,26(12):2826-2827.
[8] Sheng JQ. Development in ischemic cerebrovascular disease treatment by calcium channel blocker[J].Medical Journal of West China, 2013,25(12):1767-1769.
[9]邹晓毅,阮旭中,周树舜,等.尼莫地平对青霉素诱导的大鼠癫痫的抑制作用观察[J].华西医科大学学报,1987,28:383.
[10] Sakaida I, Terai S, Nakajima K, et al. Predictive factors of the pharmacological action of tolvaptan in patients with liver cirrhosis:a post hoc analysis[J]. Journal of Gastroenterology, 2017,52(2):1-8.
[11] Hamani C, Zanetti MV, Pinto FC, et al. Intraventricular pressure monitoring in patients with thalamic and ganglionic hemorrhages[J]. Arquivos de NeuroPsiquiatria, 2003,61(2B):376-380.
[12]杨正东.穿刺治疗基底节区脑出血与内科治疗近期疗效对比[J].中外医疗,2016,35(8):72-73.