乌拉地尔与硝普钠治疗高血压脑出血术后早期再出血的临床疗效比较

Comparison of clinical efficacy between urapidil and sodium nitroprusside in the treatment of early rebleeding after hypertensive cerebral hemorrhage

目的比较乌拉地尔与硝普钠治疗高血压脑出血术后早期再出血的临床疗效。方法选取2019年1月至2022年2月于抚州市第一人民医院诊疗的80例高血压脑出血患者作为研究对象,随机分为乌拉地尔组与硝普钠组,每组40例。乌拉地尔组术后给予乌拉地尔治疗,硝普钠组术后给予硝普钠治疗,比较两组治疗前后血肿体积、运动功能、神经功能缺损、疾病相关参数及不良反应发生情况。结果两组血肿体积组间、时间比较差异有统计学意义(P<0.05);两组血肿体积交互比较差异无统计学意义。组内比较:两组治疗后各时间点血肿体积均小于前一时间点,差异有统计学意义(P<0.05)。组间比较:治疗前,两组血肿体积比较差异无统计学意义;治疗后1、2、4周,乌拉地尔组血肿体积均小于硝普钠组,差异有统计学意义(P<0.05)。治疗后,两组CSS评分、运动神经评分均高于治疗前,且乌拉地尔组高于硝普钠组,差异有统计学意义(P<0.05)。治疗后,乌拉地尔组血浆黏度、红细胞沉降率、全血低切还原黏度、收缩压和舒张压均低于硝普钠组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论乌拉地尔治疗高血压脑出血患者早期再出血的疗效显著,可有效减少患者血肿体积,改善神经损伤,有利于运动功能恢复,且安全性高,值得临床推广应用。

Objective To compare the clinical efficacy of urapidil and sodium nitroprusside in the treatment of early rebleeding after hypertensive cerebral hemorrhage.Methods 80 patients with hypertensive cerebral hemorrhage in the First People's Hospital of Fuzhou City from January 2019 to February 2022 were selected as the research subjects,and they were randomly divided into the urapidil group and the sodium nitroprusside group,with 40 cases in each group.The urapidil group was treated with Urapidil after operation,and sodium nitroprusside group was treated with sodium nitroprusside after operation.The hematoma volume,motor function,neurological deficit before and after treatment and disease-related parameters,adverse reactions were compared between the two groups.Results There were significant differences in hematoma volume between the two of groups and time points(P<0.05);there were significant differences in hematoma volume between the two of interaction.Comparison within group:the hematoma volume of the two groups at each time point after treatment was smaller than that of the previous time point,with statistical significance,and the difference was statistically significant(P<0.05).Comparison between groups:before treatment,there was no significant difference in hematoma volume between the two groups;at the 1st,2nd and 4th week after treatment,the hematoma volume of urapidil group was smaller than that in the sodium nitroprusside group,and the difference was statistically significant(P<0.05).After treatment,the CSS score and motor nerve score of the two groups were higher than those before treatment,and the urapidil group was higher than that in the sodium nitroprusside group,and the difference was statistically significant(P<0.05).After treatment,the plasma viscosity,erythrocyte sedimentation rate,whole blood low shear reduction viscosity,systolic blood pressure and diastolic blood pressure in the urapidil group were lower than those in the sodium nitroprusside group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Urapidil is effective in the treatment of early rebleeding in patients with hypertensive cerebral hemorrhage,which can effectively reduce the hematoma volume,improve nerve injury,facilitate the recovery of motor function,and is safe and worthy of clinical promotion and application.