超早期应用氨甲环酸对脑出血患者血肿影响

Anti-fibrinolysis Therapy at Ultra-early Stage to Lessen Hematoma Enlargement Incidence of Spontaneous Intracerebral Hemorrhage

目的观察超早期快速应用氨甲环酸治疗自发性脑出血对血肿扩大发生率及预后的影响。方法150例符合入组标准的患者分成治疗组A组38例，发病3h内抗纤溶治疗，治疗组B组32例，发病3—6h内抗纤溶治疗反对照组80例。行发痛6h内、30h动态CT观察，于治疗前、治疗第7d、30d、60d行神经功能评分并进行统计学分析。结果治疗组血肿扩大发生率（2．85％）显著低于对照组（11．25％）（P〈0．01）。于发病3h内快速抗纤溶治疗效果显著。治疗组A组7d、30d、60d NIHSS评分分别为：8．32±3．12，6．42±3．40，3．16±3．06；B组; 8．32±3．12，6．42±3．40，4．26±2．96（P〈0．01）。结论脑出血超早期快速抗纤溶治疗能有效地降低血肿扩大发生率，促进神经功能缺损恢复。明显改善患者的预后。

Objective To observe the hematoma enlargement incidence and the therapeutic effects of tranexamic acid （TA） in treatment of spontaneous intracerebral hemorrhage at ultra - early stage. Methods 150 patients consistent with the inclusion criteria were divided into three groups： treatment group A （38 cases according to occurence of time within 3h were treated with tranexamic acid） ,treatment group B（32 cases from 3 to 6h were treated with tranexamic acid）and control group （80 cases）. All patients in three groups were examined with CT- scan within 6h and reexamined 30h after the onset. NIH Stroke Scale were evalued at different times before and after treatment in three groups. Data were statistical analyzed. Results CT scaning showed that the hematoma enlargement incidence of treatment group less notable （ 2. 85% vs 11.25% ） （ P 〈 0. 01 ）. And it had significant difference between treatment group A and control. NIH Stroke Scale of treatment group （8.32 ±3.12, 6. 42 ±3.40, 3.16 ±3.06） decreased at 7d,30d,60d（ P 〈0. 01）. Conclusion The fas anti - fibrinolysis therapy can validly lessen hematoma enlargement incidence intreament of spontaneous intracerebral hemorrhage at the ultra - early stage, promote the nerve function deficient recovery, and significantly improve prognosis of cerebral hemorrhage patients.