地塞米松血肿腔内注入治疗脑血肿周围水肿疗效分析

THE NEW THERAPY FOR PERIHEMATOMAL BRAIN EDEMA: DEXAMETHASONE INJECTION INTO THE CAVITY OF HEMATOMA

目的 观察锥颅血肿引流术联合血肿腔内注入氟美松对脑出血患者血肿周围水肿的疗效。方法 82例经锥颅血肿引流术治疗的脑出血患者被分为 2组。 46例在锥颅术后被给予血肿腔内注入氟美松 ,每日经插至血肿中心的硅胶管注入氟美松 5mg ,连用 5d。与对照组比较神经功能缺损评分和血肿周围水肿大小。结果 锥颅术 5d后 ,血肿周围水肿在氟美松组明显比对照组减轻 (P <0 .0 1 ) ;氟美松组的患者术后 5d(P <0 .0 1 )和 1 4d(P <0 .0 1 )的神经功能缺损评分均比对照组明显改善。结论 锥颅血肿引流术结合血肿腔内注入氟美松可明显减轻脑血肿周围水肿 ,并改善脑出血患者的神经功能缺损评分。

Objective To investigate the clinical effects of dexamethasone injection into the cavity of hematoma combined with craniopuncture for the perihematomal edema on the patients with cerebral hemorrhage. Methods 82 patients with cerebral hemorrhage, who had been treated by craniopuncture,were divided into 2 groups. 46 of which were administered a daily injection of dexamethasone(DXM) into the cavity of hematoma following craniopuncture, via a silicone tube which had inserted into the centre of the hematoma, and lasted 5 days. The sizes of perihematomal edema and the neurological functional scores were compared with the control group. Results It is showed that the perihematomal brain edema in DXM group decreased significantly 5 days after craniopuncture than those in control group(P<0.01), and the neurological functional scores in DXM group improved significantly both in 5 days (P<0.01)and 14 days (P<0.01)after craniopuncture than those in control group. Conclusion Injection of dexamethasone into the cavity of hematoma combining with craniopuncture could decrease the perihematomal brain edema degree and improve the neurological functional scores of the patients who suffer from cerebral hemorrhage.