高血压脑出血患者早期应用香丹注射液活血化淤效果观察与护理

Observation of the Therapeutic Effect of Early Use of Xiangdan Parenteral Solution on Early Hypertensive Encephalorrhagia

目的观察高血压脑出血患者早期应用香丹注射液活血化淤治疗的效果。方法选择2004年1月-2005年12月45例高血压脑出血患者,按随机数字表法随机分成治疗组23例,对照组22例;对照组予常规脱水、降压、维持水电解质平衡、营养脑细胞等治疗;治疗组在对照组的基础上用5%葡萄糖250 ml加入香丹注射液10 ml静滴,每日1次。治疗1周后通过头颅CT检查观察脑出血量的变化情况。结果治疗组治疗前后脑血肿吸收量比较差异有统计学意义(P<0.01);两组治疗后脑血肿吸收量比较差异有统计学意义(P<0.05);治疗组治疗前后神经功能缺损评分比较差异有统计学意义(P<0.01)。结论早期应用香丹注射液活血化淤法治疗高血压脑出血能有效促进血肿的吸收。认为活血化淤治疗期间护理上应密切观察病情变化及不良反应,患者头痛剧烈、呕吐频繁并呈喷射状、烦躁不安、意识迟钝、瞳孔不等大、呼吸不规则,提示出血量增加有可能发生脑疝,需密切观察颅内压变化。用药前询问患者有无药物过敏史与家族史,用药期间严密观察有无头晕、心慌、气促等过敏反应症状。掌握该药的配伍禁忌,禁止与其混合后即产生沉淀的药品如利多卡因、庆大霉素、异丙嗪等配伍,合理安排好输液顺序是确保疗效的关键。

Objective To study the therapeutic effect of early use of Xiangdan parenteral solution on early hypertensive encephalorrhagia. Methods 45 patients with early hypertensive encephalorrhagia admitted from Jan. 2004 to Dec. 2005, were randomized into treatment group （n =23） and control group （n =22）. The controls were treated with routine dehydration, depressurization, keeping water electrolyte balance, nourishment of cerebral cells and the patients in the treatment group every day with 10 ml Xiangdan parenteral solution mixed into 250 ml 5% GS in addition to the treatment in the control. A week after treatment, the patients received CT examinations to observe the changes of encephalorrhagia. Results There was significant difference in absorption of cephalophyma between the groups （P〈0.01）. The difference was significant in neurologic impairment between pre- treatment and post-treatment in the treatment group （P〈0.01）. Conclusion Early use of Xiangdan parenteral solution may effectively promote the absorption of cephalophyma. During treatment, the nurses should monitor carefully the changes in intracranial pressure, blood pressure, alimentary tract hemorrhage and mentality.