硝苯地平对脑出血患者脑水肿程度及神经功能的影响

Effect of nifedipine on brain edema and neurological function in patients with cerebral hemorrhage

目的探讨硝苯地平对脑出血患者脑水肿程度及神经功能的影响。方法选取2013年10月～2015年10月杭州市余杭区第一人民医院神经内科收治的（Intracerebral hemorrhage,ICH）患者72例,随机分为实验组和对照组,每组36例。对照组采用脱水降低颅内高压,改善脑血循环、促进营养代谢及抗感染等常规治疗。实验组在对照组基础上每天静脉滴注1.0 mg硝苯地平,疗程10天。观察比较2组ICH患者治疗前后活动依赖程度、临床疗效、MESS评分、BI评分、脑血肿及脑水肿体积。结果治疗后,实验组活动依赖程度显著优于对照组（P〈0.05）,实验组临床有效率显著高于对照组（P〈0.05）;2组患者治疗后BI评分均升高,MESS评分均降低;实验组BI评分显著高于对照组,2组比较差异有统计学意义（P〈0.05）;实验组MESS评分显著低于对照组,2组间比较差异有统计学意义（P〈0.05）。2组治疗后脑血肿体积和脑水肿体积均明显缩小,2组脑血肿体积比较差异无统计学意义,2组脑水肿体积比较差异有统计学意义（P〈0.05）。结论硝苯地平能有效减轻脑出血患者的脑水肿程度,降低神经功能缺损程度,提高临床疗效。

Objective To investigate the effect of nifedipine on brain edema and neurological function in patients with cerebral hemorrhage.Methods 72 patients with ICH from October 2013 to October 2015 in our hospital were selected,and randomly divided into experimental group and control group,36 cases in each group.The control group used dehydration to reduce intracranial hypertension,improve cerebral circulation,promote nutritional metabolism and anti infection and other conventional treatment,and the experimental group daily intravenous infusion of 1.0 mg of nifedipine on the basis of control group,a course of ten days.The activity dependence,clinical efficacy,MESS score,ICH score,BI score,brain hematoma and brain edema volume were observed and compared between the two groups before and after treatment.Results After treatment,the activity dependence of the experimental group was significantly better than that of the control group（P〈0.05）;the clinical effective rate of the experimental group was significantly higher than that of the control group（P〈0.05）.BI scores of both groups were increased after treatment,MESS scores were reduced（P〈0.05）;The BI score of the experimental group was significantly higher than that of the control group（P〈0.05）,and the MESS score was significantly lower than that of the control group（P〈0.05）.The volume of cerebral hematoma and the volume of cerebral edema were significantly reduced after treatment in both groups（P〈0.05）,there was no significant difference in the volume of cerebral hematoma between two groups,there was significant difference in the volume of cerebral edema between two groups（P〈0.05）.Conclusion Nifedipine can effectively reduce cerebral edema in patients with cerebral hemorrhage,reduce the degree of neurological deficit,improve clinical efficacy.