微创血肿碎吸引流术联合尼莫地平治疗高血压脑出血临床研究

目的:观察微创血肿碎吸引流术联合尼莫地平对高血压性脑出血患者的疗效。方法:高血压脑出血患者48例,随机分为A组25例和B组23例。2组均采用微创血肿碎吸引流术及脱水、止血、抗炎、控制血压等治疗,A组同时给予尼莫地平。于第7、14、21天行CT检查以测量周围水肿体积,NI HSS评定神经功能缺损及死亡和再出血情况。结果:A组与B组比较血肿周围水肿体积显著减小(P<0.05),NI HSS评分明显降低(P<0.01)。2组死亡例数无显著性差异,A组无再出血及持续出血。结论:尼莫地平能有效减轻行微创血肿碎吸引流术的高血压性脑出血患者的脑水肿,促进神经功能恢复。

Clinical Study of Minimally Traumatic Puncture Drainage of Hematoma Combined with Nimodipine in the Treatment of Hypertensive Cerebral Hemorrhage

Objective: To observe the effect of nimodipine on patients with hypertensive cerebral hemorrhage after minimally traumatic puncture draining of hematoma. Methods: 48 cases were randomly divided in two groups, 25 in therapeutic group and 23 in control group. All the patients have received minimally traumatic puncture draining of hematoma, dehydration therapy, hemostatics, anti-inflammatory agents and anti-hypertensive agents. In addition, on the patients in the therapeutic group, nimodipine was continuously intravenously pumped at 0.5-1mg/h for two weeks. Cranial CT was performed to measure the volume of perilesional edema and neurologic deficits were assessed at 7th, 14th and 21st day after initiating the therapy. Results: The area of perilesional edema in therapeutic group was conspicuously diminished when compared with the control group (p<0.05). Accordingly, neurological function was significantly improved (P<0.01). Conclusion: Nimodipine can effectively reduce edema around the hematoma and promote the recovery of neurological function in patients with hypertensive cerebral hemorrhage after minimally traumatic puncture drainage.