托拉塞米对基底核区中等量脑出血行软通道穿刺引流术后患者脑水肿状态及神经功能的影响

Effects of torasemide on cerebral edema and nerve function in patients with moderate intracerebral hemorrhage in the basal ganglia region after soft channel puncture and drainage

目的:探究托拉塞米对基底核区中等量脑出血行软通道穿刺引流术后患者的手术效果及神经损伤修复的影响。方法:选取本院2018年9月至2019年9月收治的129例基底核区中等量脑出血患者,按照制定方案不同分为对照组和观察组。对照组64例给予软通道穿刺引流术治疗,观察组65例增加托拉塞米治疗,对比两组患者临床疗效,术后7 d脑水肿体积,手术效果、神经功能及不良反应。结果:观察组的临床总有效率高于对照组(P<0.05);观察组术后7d脑水肿体积、术中出血量、手术时间、脑室出血清除时间、脑脊液恢复正常时间水平均低于对照组(P<0.05);两组CNDS评分治疗后7~30 d呈逐渐降低趋势,且观察组低于对照组(P<0.05);对照组总不良反应率高于观察组,但两组比较差异无统计学意义(P>0.05)。结论:托拉塞米联合软通道穿刺引流术治疗基底核中等量脑出血患者通过减缓红细胞裂解速度以降低神经细胞损害,调节神经功能,缩小脑水肿体积,改善手术效果,安全性高,提高临床疗效。

Objective:To investigate the effects of torasemide on cerebral edema and neurological function in patients with moderate intracerebral hemorrhage in the basal ganglia region after soft channel puncture and drainage.Methods:129 patients with moderate cerebral hemorrhage in the basal ganglia region treated in our hospital from September 2018 to September 2019 were divided into the control group and the observation group according to the different formulations.64 patients in the control group underwent soft channel puncture and drainage,while another 65 patients in the observation group were treated with torasemide.The clinical effects,the volume of brain edema,surgical effect,neurological function,and adverse reactions were compared between both groups.Results:The total clinical effective rate of the control group was higher than that of the observation group(P<0.05).The brain edema volume,intraoperative blood loss,operation time,ventricular hemorrhage clearance time,and the time to return to normal cerebrospinal fluid in the control group were lower than those in the observation group(P<0.05).The CNDS scores of the two groups showed a gradual decrease from 7 days to 30 days after treatment,and the observation group was lower than the control group(P<0.05).The total adverse reaction rate of the control group was higher than that of the observation group(P>0.05).Conclusion:Torasemide combined with soft channel puncture drainage in the treatment of patients with moderate intracerebral hemorrhage in the basal ganglia region can reduce nerve cell damage,regulate neurological function,reduce cerebral edema volume,and improve surgical effects by slowing down the speed of red blood cell lysis.