早期强化降压联合尼莫地平治疗高血压脑出血临床疗效观察
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摘要
目的探讨联合应用早期降压和尼莫地平治疗高血压脑出血患者的治疗效果。方法顺序选取2016年7月—2017年7月平煤神马医疗集团总医院神经内科收治的脑出血患者84例,随机分为治疗组和对照组,每组42例,治疗组采用选取乌拉地尔注射液早期强化降压治疗,将患者收缩压降至140 mm Hg(1 mm Hg=0.133 kPa)以下。对照组患者给予常规降压治疗,将患者收缩压降至140～180 mm Hg;同时治疗组给予尼莫地平片口服,对照组给予依达拉奉注射液静滴,治疗时间为8周。观察两组患者血肿体积及NHISS评分。结果两组患者经治疗后血肿扩大程度、NHISS评分均有一定程度改善。治疗组血肿体积为(15.01±1.58)cm~3,对照组血肿体积为(19.24±1.33)cm~3,两组差异具差异有统计学意义(P<0.05)。治疗组NHISS评分为(11.60±3.45)分,对照组NHISS评分为(15.24±2.56)分,两组差异具有统计学意义(P<0.05)。结论早期降压联合尼莫地平治疗高血压脑出血患者具有较好的临床疗效。
Objective To investigate the therapeutic effect of early active antihypertensive therapy combined with nimodipine on hypertensive intracerebral hemorrhage patients.Methods Totally 84 patients with hypertensive intracerebral hemorrhage received treatment in department of neurology of our hospital from July 2016 to July 2017 were selected and randomly divided into treatment group(42 cases) and control group(42 cases). The treatment group patients received early active antihypertensive therapy with Urapidil injection in order to keep the systolic pressure under 140 mm Hg, the control group patients received conventional antihypertensive therapy to keep the systolic pressure between 140 and 180 mm Hg. While the treatment group patients received nimodipine orally and the control group patients received edaravone by injection. Total treatment time was 8 weeks. The clinical effect was evaluated by comparing the hematoma volume and NHISS score of two groups.Results There were improvement on hematoma volume changes and NHISS score for both groups after treatment. The hematoma volume of treatment group was(15.01±1.58)cm~3, while the hematoma volume of contol group was(19.24±1.33)cm~3, the difference between the two groups was statistically significant(P<0.05). The NHISS score of the treatment group was(11.60±3.45)points, the NHISS score of the control group was(15.24±2.56)points, the difference between the two groups was statistically significant(P<0.05).Conclusion The clinical effect of combination of early active antihypertensive therapy and nimodipine is good.
Objective To investigate the therapeutic effect of early active antihypertensive therapy combined with nimodipine on hypertensive intracerebral hemorrhage patients.Methods Totally 84 patients with hypertensive intracerebral hemorrhage received treatment in department of neurology of our hospital from July 2016 to July 2017 were selected and randomly divided into treatment group(42 cases) and control group(42 cases). The treatment group patients received early active antihypertensive therapy with Urapidil injection in order to keep the systolic pressure under 140 mm Hg, the control group patients received conventional antihypertensive therapy to keep the systolic pressure between 140 and 180 mm Hg. While the treatment group patients received nimodipine orally and the control group patients received edaravone by injection. Total treatment time was 8 weeks. The clinical effect was evaluated by comparing the hematoma volume and NHISS score of two groups.Results There were improvement on hematoma volume changes and NHISS score for both groups after treatment. The hematoma volume of treatment group was(15.01±1.58)cm~3, while the hematoma volume of contol group was(19.24±1.33)cm~3, the difference between the two groups was statistically significant(P<0.05). The NHISS score of the treatment group was(11.60±3.45)points, the NHISS score of the control group was(15.24±2.56)points, the difference between the two groups was statistically significant(P<0.05).Conclusion The clinical effect of combination of early active antihypertensive therapy and nimodipine is good.
引文
[1] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-443.
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[4] 张钶,霍钢,王晓澍,等.早期强化降压对高血压脑出血患者颅内血肿及水肿的影响[J].第三军医大学学报,2016,38(7):757-760.
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[7] 宋维根,钟建国,陈敏,等.脑出血超早期强化降压对后期功能恢复的影响[J].江苏医药,2015,41(7):834-835.
[8] 李红旗,张玉芝,臧永强,等.高血压脑出血后二次脑损伤相关因素对预后的影响[J].中风与神经疾病杂志,2013,30(3):248-250.
[9] 刘涛,宁波,马宇洁.局部亚低温联合尼莫地平防治重型颅脑损伤术后脑血管痉挛的疗效研究[J].癫痫与神经电生理学杂志,2016,25(1):15-19.
[10] 周晓香,姚汉云.尼莫地平对脑出血患者血浆神经肽Y及超敏C反应蛋白水平的影响研究[J].实用心脑肺血管病杂志,2015,23(8):28-30.
[2] 宋维根,钟建国,肖佩荣,等.高血压脑出血患者早期强化降压对血肿扩大的影响[J].临床神经病学杂志,2010,23(1):58-60.
[3] 魏利军.尼莫地平治疗脑出血后缺血性脑损伤临床观察[J].中国实用神经疾病杂志,2016,19(23):93-94.
[4] 张钶,霍钢,王晓澍,等.早期强化降压对高血压脑出血患者颅内血肿及水肿的影响[J].第三军医大学学报,2016,38(7):757-760.
[5] Davis SM, Broderick J, Hennerici M, et al. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage[J]. Neurology. 2006,66(8):1175-1181.
[6] Ohwaki K, Yano E, Nagashima H, et al. Blood pressure management in acute intracerebral hemorrhage: relationship between elevated blood pressure and hematoma enlargement[J]. Stroke, 2004,35(6):1364-1367.
[7] 宋维根,钟建国,陈敏,等.脑出血超早期强化降压对后期功能恢复的影响[J].江苏医药,2015,41(7):834-835.
[8] 李红旗,张玉芝,臧永强,等.高血压脑出血后二次脑损伤相关因素对预后的影响[J].中风与神经疾病杂志,2013,30(3):248-250.
[9] 刘涛,宁波,马宇洁.局部亚低温联合尼莫地平防治重型颅脑损伤术后脑血管痉挛的疗效研究[J].癫痫与神经电生理学杂志,2016,25(1):15-19.
[10] 周晓香,姚汉云.尼莫地平对脑出血患者血浆神经肽Y及超敏C反应蛋白水平的影响研究[J].实用心脑肺血管病杂志,2015,23(8):28-30.