亚低温联合丁苯酞注射液治疗高血压脑出血微创血肿清除术后32例继发性脑梗死的临床疗效观察

Contribution of cooperative effect of local mild hypothermia therapy and intravenous infusion of butylphthalide on the treatment of 32 patients with cerebral infarction after the micro-invasives surgery for hypertension-induced hemorrhage

目的观察亚低温联合丁苯酞注射液治疗高血压脑出血微创血肿清除术后继发性脑梗死的临床疗效。方法选择高血压脑出血微创血肿清除术后继发脑梗死患者94例,按不同治疗方式随机分为亚低温组29例、丁苯酞组33例和联合治疗组32例、。采用NIHSS评分法评估三组治疗前及治疗后7天、14天、30天的临床疗效,同时对比三组治疗前及治疗后第3天、7天、14天的缺血灶大小。结果治疗7天后,三组NIHSS评分差异无统计学意义(P>0.05);治疗14天、30天后,联合治疗组NIHSS评分较亚低温组和丁苯酞组均显著降低(所有P<0.01),而亚低温组和丁苯酞组NIHSS评分差异无统计学意义(所有P>0.05);治疗3天后,联合治疗组缺血灶大小较亚低温组和丁苯酞组明显减少(所有P>0.05);而亚低温组和丁苯酞组缺血灶大小减少差异无统计学意义(P>0.05)。治疗7天后,联合治疗组缺血灶大小较亚低温组明显减少(P<0.01);治疗14天后,联合治疗组缺血灶大小较亚低温组明显减少(P<0.01),丁苯酞组缺血灶大小较亚低温治疗组也明显减少(P<0.05);但联合治疗组和丁苯酞组缺血灶大小减少差异无统计学意义(P>0.05)。结论早期亚低温联合丁苯酞注射液治疗能显著减小高血压脑出血微创血肿清除术后继发脑梗死患者的缺血灶体积、降低NIHSS评分。

Objective To determine the cooperative effect of LMH and intravenous infusion of butylphthalide on the treatment of 32 patients with cerebral infarction.Methods Nine-four cases with cerebral infarction after the micro-invasive surgery were randomly divided into 3 groups.Clinical outcomes and Ischemia volume were assessed.Results Compared with LMH group and butylphthalide group,NIHSS scores in cooperative treatment group were significantly decreased respectively at 14-day and 30-day.Compared with LMH group and butylphthalide group,hematoma volume in cooperative treatment group was significantly decreased at 3-day.Compared with LMH group,hematoma volume in cooperative treatment was markedly decreased at 7-day.Compared with LMH group,ischemia volumes in other 2 groups were significantly decreased at 14-day.Conclusions Combined LMH therapy and intravenous infusion of butylphthalide can benefit to the ischemia volume elimination and neurons survival in the ischemic penumbra region.