七叶皂苷钠对桥小脑角区脑膜瘤术后脑水肿和神经功能的改善作用

Improvement of Brain Edema and Nerve Function by Sodium Aescinate after Cerebellopontine Angle Meningioma Operation

目的探讨七叶皂苷钠改善桥小脑角区脑膜瘤术后脑水肿和神经功能的作用。方法选取医院2011年1月至2014年4月收治的桥小脑角区脑膜瘤患者40例,随机分为对照组和观察组,各20例。两组患者均进行显微手术,术后给予止血、抗感染等基础治疗,观察组患者加用七叶皂苷钠20 mg静脉滴注。观察两组患者的生存状况和肿瘤复发情况,监测脑水肿的体积,评价神经功能和日常生活活动能力的改善情况,记录药品不良反应的发生情况。结果两组患者手术结果、死亡率和复发率均无显著性差异(P>0.05),但观察组症状改善程度明显优于对照组(P<0.05);术后3 d时两组患者脑水肿体积差异无统计学意义(P>0.05),术后1周和2周时观察组脑水肿体积均明显小于对照组(P<0.05);治疗后,两组患者神经功能评分均较治疗前显著下降,且观察组下降幅度更大(P<0.05);两组患者治疗后Barthel(BI)指数评分均较治疗前显著上升,且观察组上升程度更大(P<0.05)。治疗过程中,观察组患者未出现与七叶皂苷钠相关的药品不良反应。结论桥小脑角区脑膜瘤手术后给予七叶皂苷钠治疗,临床疗效好,能减轻脑水肿、改善神经功能,安全性高,值得临床推广。

Objective To investigate the improvement of brain edema and neurological function by sodium aescinate after cerebellopontine angle meningioma operation. Methods 40 cases of cerebellopontine angle meningiomas admitted to our hospital from January 2011 to April 2014 were selected and randomly divided into the control group and the observation group,20 cases in each group. The two group were performed the microsurgery and were postoperatively given the basic therapy of hemostasis,anti- infection,etc. The observation group was added with sodium aescinate 20 mg by intravenous drip. The survival status and tumor recurrence situation were observed. The brain edema volume was monitored. The improvement situation of nerve function and activity of daily living was evaluated.The adverse drug reactions were recorded. Results The operative results,death rate and recurrence rate had no statistical differences between the two groups（ P 0. 05）,but the symptom improvement degree in the observation group was superior to the control group（ P 0. 05）; the brain edema volume on postoperative 3 d had no statistical difference between the two groups（ P 0. 05）; the brain edema volume at postoperative 1,2 weeks in the observation group was significantly less than that in the control group with statistical difference（ P 0. 05）; the nerve function score after treatment in the two group were significantly decreased compared with before treatment,moreover the decrease range in the observation group was greater（ P 0. 05）; the BI score after treatment in the two groups was significantly increased,but the increase range in the observation group was greater（ P 0. 05）. No adverse reactions related with sodium aescinate occurred. Conclusion Giving Sodium aescinate after cerebellopontine angle meningioma operation has good clinical effect,can alleviate brain edema,improve the nerve function with high safety,which is worthy of clinical promotion.