氨甲环酸联合矛头蝮蛇血凝酶治疗外伤后脑出血患者头颅CT变化及临床疗效

目的研究氨甲环酸联合矛头蝮蛇血凝酶治疗外伤后脑出血患者的头颅CT变化及临床治疗效果。 方法选择吴川市人民医院神经外科一区和广东医科大学附属医院自2016年1月至2017年12月收治的136例TBI后脑出血患者作为研究对象，分为试验组和对照组，每组68例。对照组给予矛头蝮蛇血凝酶，试验组在矛头蝮蛇血凝酶的基础上联合使用氨甲环酸，头颅CT检测患者颅内血肿的变化情况及影像学特征，比较2组患者脑出血血肿增大的发生率、治疗疗效、并发症和临床预后。 结果试验组中血肿继续增加和达到手术指征的患者（3例、1例)均显著少于对照组（10例、8例)，差异有统计学意义（P<0.05）。患者头颅CT检查显示试验组患者血肿量逐渐吸收，血肿周围水肿情况较对照组更轻。试验组患者的肺部感染、褥疮的发生率明显低于对照组，差异具有统计学意义（P<0.05），而深静脉感染、泌尿系感染、营养不良方面则差异无统计学意义（P>0.05）；试验组患者在疾病恢复期第3、6、9个月的日常生活能力评分（ADL）均显著高于对照组，差异具有统计学意义（P<0.05）。 结论氨甲环酸联合矛头蝮蛇血凝酶预防性用药能够降低脑创伤后脑内出血血肿增大的发生率，且能够改善临床治疗效果。

CT changes and clinical efficacy of tranexamic acid combined with hemocoagulase bothrops atrox in the treatment of patients with cerebral hemorrhage after trauma

ObjectiveTo study the clinical effect of tranexamic acid combined with hemocoagulase bothrops atrox on preventing hematoma enlargement after traumatic cerebral hemorrhage. MethodsOne hundred and thirty-six exception injury after cerebral hemorrhage patients admitted to District 1 of Neurosurgery Department of Wuchuan People’s Hospital and Affiliated Hospital of Guangdong Medical University from January 2016 to December 2017 were selected as the research object, and they were randomly divided into experimental group and control group, 68 cases respectively. Control group were given hemocoagulase bothrops atrox, experiment group were given hemocoagulase bothrops atrox combination of tranexamic acid. Then compare two groups of patients with cerebral hemorrhage haematoma increases the incidence of differences, treatment efficacy and complications, and clinical outcomes. ResultsIn the experimental group, hematoma continued to increase and reached the operation indication (3 cases, 1 case) were significantly less than the control group (10 cases, 8 cases), the differences were statistically significant (P<0.05). CT examination of the patient’s head showed that the amount of hematoma in the experimental group was gradually absorbed, and the hematoma surrounding edema was lighter than that in the control group. The incidence of pulmonary infection and bedsore in the experimental group was significantly lower than that in the control group (P<0.05), but there was no significant difference in deep vein infection, urinary tract infection and malnutrition (P>0.05). The ADL scores of the experimental group was significantly higher than that of the control group at the 3^rd, 6^th and 9^th month of the recovery period (P<0.05). ConclusionTranexamic acid combined with hemocoagulase bothrops atrox can reduce the incidence of intracerebral hemorrhage hematoma after traumatic brain injury and improve the clinical treatment effect.