天麻素治疗急性脑出血的临床观察

目的探讨天麻素对脑出血患者急性的治疗效果。方法对急诊109例脑出血患者,随机分为两组,治疗组56例,对照组53例,对照组采用20%甘露醇125～250ml,每4～8h静脉滴注,常规抗生素预防感染,胃酸抑制剂防治上消化道出血,以及对症、支持治疗。治疗组除了给予对照组药物治疗外,加用天麻素6ml/d治疗。并对患者治疗前后危重情况进行APACHEⅡ临床评分,对治疗前后脑出血的量、治疗期间发生的并发症和死亡率以及药物的不良反应进行观察。结果治疗组和对照组在治疗7d后,APACHEⅡ评分为20.6±6.8、23.8±6.6,两组之间有显著差别（p〈0.05）,同一组在治疗前后APACHEⅡ评分亦有显著差别（p〈0.01）。治疗组与对照组脑出血量在治疗7d后比较无明显差别（p〉0.05）,但同组之间比较,治疗后的出血量较治疗前有明显的减少（p〈0.05）。研究组共病亡6人,对照组病亡5人,治疗组发生各类并发症为8人,对照组7人,主要为脑疝和肺部感染,两组之间比较无明显差异（p〉0.05）。结论急性脑出血病人,早期使用天麻素可改善患者的预后;急性脑出血病人早期使用天麻素不增加脑血肿进一步扩大的风险。

Observe the therapeutic effect of gastrodin on patients with acute cerebral hemorrhage

Objective Observe the therapeutic effect of gastrodin on patients with acute cerebral hemorrhage.Methods 109 patients with acute cerebral hemorrhage, were divide into 2 groups （treatment group 56 cases, control group 53 cases）.The patients of control group were treated with 20% mannitol 125-250ml once every 4-8hours, and drug of antibiotic and support therapy and relievable syndrome, and inhibitor of gastric acid.The patients of treatment group were treated with gastrodin 6ml beside same drug with control groups.The neurological impairment degree （APACHE Ⅱ）, brain bleeding amount, complication, mortality, drug side effects were observed before and after treatment.Results There was significant difference in APACHEⅡ volume （20.6±6.8 Vs 23.8±6.6） between the treatment group and control group （p〈0.05）.There was significant difference before and after treatment in same group （p〈0.01）.In brain bleeding amount, there was significant difference in same group （p〈0.05）, wasn＇t difference between two group after treatment 7 days （p〈0.05）.6 patients in treatment group and 5 patients died of cerebral herniation and peptic bleeding and pneumonia.Conclusion Patients with acute cerebral hemorrhage have a good prognosis after early using gastrodin.It isn＇t increase risk on progressive extension of brain hematoma to early using gastrodin in the patient with acute cerebral hemorrhage.