醒脑静联合盐酸法舒地尔在高血压脑出血术后的疗效观察

Observation on the curative effect of Xingnaojing injection combined with fasudil hydrochloride in hypertensive intra-cerebral hemorrhage after operation

目的:观察醒脑静联合盐酸法舒地尔在高血压脑出血术后治疗的临床有效性和安全性。方法:90例高血压脑出血患者随机分为对照组和观察组,每组45例。在常规治疗的基础上,对照组给予醒脑静注射液静脉滴注(40 ml,qd);观察组在对照组的基础上加用盐酸法舒地尔静脉滴注(30 mg,bid)。观察治疗过程中各组患者体温、脑血管痉挛情况;采用格拉斯哥昏迷评分评定治疗前及治疗第1,7,14天各组患者意识状况;比较各组治疗期间多器官功能障碍综合征的发生率及死亡率。结果:(1)与对照组比较,观察组患者高热率及高热持续时间均明显降低(P<0.05);(2)与术前比较,2组手术后7 d和14 d VmMCA均明显升高(P<0.05);观察组在缓解高血压脑出血术后脑血管痉挛的效果显著优于对照组(P<0.05);(3)治疗7 d和14 d时,观察组GCS评分明显高于对照组,差异具有显著性(P<0.05);(4)观察组多器官功能障碍综合征(MODS)发生率明显低于对照组(P<0.05);发病后7 d死亡率各组间差异无显著性(P>0.05);(5)各组均未发现药物相关的不良反应和肝肾功能损害。结论:醒脑静联合盐酸法舒地尔可有效控制高血压脑出血术后高热、缓解脑血管痉挛、促进意识恢复、减少MODS的发生。

OBJECTIVE To observe the clinical efficacy and safety of Xingnaojing injection combined with fasudil hydrochlo- ride in hypertensive intra-cerebral hemorrhage after operation. MTEHODS 90 cases of patients with hypertensive intra-cerehral hemorrhage were randomly divided into control group and observation group, 45 cases in each group. On the basis of conven- tional therapy, the patients of control group were given with Xingnaojing injection （40 ml, qd）; the study group was given fa- sudil hydrochloride intravenous injection （30 rag, bid） besides Xingnaojing injection. Body temperature and cerebral vasospasm were observed in treatment process〈 the Glasgow coma score was adopted to assess the state of consciousness of patients before and 1,7,14 d after treatment, the incidence rate and mortality rate of multiple organ dysfunction syndrome were compared dur- ing the treatment. RESULTS （1）Compared with those in the control group, the high rate and the duration of fever of the pa- tients in observation group was significantly decreased （P〈0. 05） ; （2）compared with before operation, VmMCA of the two groups after operation in 7 d and 14 d were significantly increased （P〈0. 05） ; the curative effect in observation group was sig- nificantly better than that of control group in relieving vasospasm of postoperative hypertensive intra- cerebral hemorrhage （P 〈0. 05） ; （3）GCS score in observation group was significantly higher than that in control group on 7 d and 14 d after operation, the difference was significant （P〈0. 05） ; （4） the incidence rate of MODS in observation group was significantly lower than that in the control group （P〈0. 05） ; there was no significant difference between the two groups in death rate in the 7 d after the onset of the disease. （5）no adverse reactions related to drugs and function damages of liver and kidney occurred in the two groups. CONCLUSION Xingnaojing combined with fasudil hydroehloride can effectively control the postoperative high fever of hypertension cerebral hemorrhage, alleviate cerebral vascular spasm, promote the recovery of consciousness and reduce the inci- dence of MODS.