术中应用水蛭素治疗出血后脑水肿

目的探讨水蛭素局部应用治疗脑出血后脑水肿的作用。方法符合研究要求的40例高血压脑出血患者,均行显微血肿清除术,随机分为两组,水蛭素组和对照组血肿残腔分别贴附水蛭素止血纱和普通止血纱。术后分期行水肿体积测定及神经功能评分。结果治疗后水蛭素组神经功能评分增加值明显高于对照组(P<0.05),水肿发生率明显低于对照组(P<0.05)。术后残腔再出血及凝血功能测定两组无差异。结论水蛭素止血纱血肿残腔贴附能有效减轻脑水肿,改善脑功能,且安全、可靠。

Curative Effect of Intra-operative Application of Hirudin to Residual Hematoma Cavity on Brain Edema after Hypertensive Cerebral Hemorrhage

Objective To explore the curative effects intra-operative application of hirudin to the residual hematomas cavity on brain edema after hypertensive cerebral hemorrhage(HCH). Methods Forty patients with HCH were randomly divided into two groups, i.e. hirudin treating group and control group. Hirudin Surgicel and normal Surgicel were used respectively in the residual hematoma cavities of hirudin and control groups after the evacuation of hematomas. The volumes of edema were observed with CT scan and the neurological function of the patients was evaluated before and after the operation. Results The neurological function of the patients was significantly better in hirudin treating group than that in the control group (P<0.05). The producing rate of cerebral edema in hirudin group was significantly lower than that in the control group (P<0.05). There was insignificant difference in postopertative cerebral rebleeding and blood coagulation function between both the groups. Conclusions Hirudin is able to relieve the postoperative cerebral edema, and to improve the neurological function in the patients with HCH. The application of hirudin to the hematoma cavity is safe.