脑出血微创术后鞘内注射地塞米松疗效观察

Therapeutic effect of intrathecal dexamethasone after minimally invasive surgery

目的评估脑出血微创血肿引流术后鞘内注射地塞米松对脑出血患者颅内血肿周围水肿的疗效。方法 162例经微创血肿引流术治疗的脑出血患者随机被分为观察组(81例)和对照组(81例)。观察组微创术后给予血肿腔内注射地塞米松,每日2 mg,连用5 d;对照组鞘内未注射地塞米松外,其治疗方法等均与观察组保持一致,以2组血肿周围水肿大小和神经功能缺损作为评分标准。结果观察组微创术后7 d和14 d血肿周围水肿大小较对照组明显减小,差异有统计学意义(P<0.05或P<0.01);观察组术后7 d和14 d神经功能缺损评分与对照组比较明显改善,差异有统计学意义(P<0.05或P<0.01)。2组在治疗过程中未见相关的药物不良反应。结论脑出血微创术后鞘内注射地塞米松可明显减轻脑血肿周围水肿,并能促进脑出血患者的神经功能恢复。

Objective To evaluate the efficacy ofintrathecal dexamethasone in the treatment of intracerebral hematoma around cerebral hemorrhage after cerebral hemorrhage. Methods 162 patients with cerebral hemorrhage treated with minimally invasive hematoma drainage were randomly divided into observation group (81 cases) and control group (81 cases).In the observation group,intraperitoneal injection of dexamethasone was given to the hematoma,2 mg daily for 5 days;the control group was not injected with dexamethasone,and the treatment methods were consistent with the observation group.Peripheral edema size and neurological deficits were used as scoring criteria. Results The edema around the hematoma was significantly lower in the observation group than in the control group at 7 and 14 days after minimally invasive surgery.The difference was statistically significant ( P <0.05 or P <0.01).The neurological deficit at 7 and 14 days after operation in the observation group.The scores were significantly improved compared with the control group,and the difference was statistically significant ( P <0.05 or P <0.01).There were no adverse drug reactions in the two groups during the treatment. Conclusion Intrathecal injection of dexamethasone after minimally invasive cerebral hemorrhage can significantly reduce edema around the cerebral hematoma and promote the recovery of neurological function in patients with cerebral hemorrhage.