血凝酶在防治高血压脑出血患者血肿再扩大中的应用

The application of hemocoagulase for prevention and treatment of the widened hematoma in patients with hypertensive cerebral hemorrhage

目的探讨血凝酶在防治高血压脑出血患者血肿再扩大中的应用价值。方法选取2016年1月～2018年1月期间本院神经内科住院部高血压脑出血患者128例,根据治疗方法采用随机数字表法按照1∶1比例将患者分为两组,各64例,对照组采用常规治疗,研究组患者在上述基础上采用血凝酶。比较两组血肿再扩大率、近远期疗效与药物安全性的差异。结果研究组血肿再扩大率为3. 13%,明显低于对照组的20. 31%(13/64),P <0. 05。与治疗前比较,两组治疗后血肿量明显减少,P <0. 05。治疗后,研究组血肿量明显少于对照组,P <0. 05。研究组治疗总有效率(95. 31%)明显高于对照组(68. 75%),P <0. 05。研究组NIHSS评分明显低于对照组,格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分明显高于对照组,P <0. 05。两组PLT、PT、TT、APTT、ALT、TBIL、BUN与SCr水平比较差异无统计学意义(P> 0. 05),两组药物不良反应发生率比较差异无统计学意义(P>0. 05)。结论血凝酶在防治高血压脑出血患者血肿再扩大中的应用显著,有助于明显改善近远期疗效,且不影响血小板、凝血与肝肾功能,具有较高的药物安全性,值得临床推广应用。

Objective To study the application value of hemocoagulase for prevention and treatment of the widened hematoma in patients with hypertensive cerebral hemorrhage. Methods 128 cases of patients with hypertensive cerebral hemorrhage from neurology wards of our hospital during the period of January 2016 and January 2018 were selected,according to the treatment using the random number table method by proportion of 1: 1,the patients were divided into two groups,each for 64 cases,control group were given conventional treatment,study group were given hemocoagulase on the basis of above. The widened hematoma,short&long term curative effect and drug safety between the two groups were compared. Results The widened hematoma of the study group 3. 13%,was significantly lower than the control group of 20. 31%,P <0. 05. Compared with pre-therapy,hematoma volume of the two groups in post-therapy were significantly less,P < 0. 05.When post-therapy,hematoma volume of the study group was significantly less than the control group,P < 0. 05. The total effective rate of the study group( 95. 31%) was significantly higher than the control group( 68. 75%),P < 0. 05. NIHSS score of the study group was significantly lower than the control group,GCS score was significantly higher than the control group,P < 0. 05. Levels of PLT,PT,TT,APTT,ALT,TBIL,BUN and SCr compared between the two groups with no statistically significant differences( P > 0. 05),the adverse drug reactions rate compared between the two groups with no statistically significant differences( P > 0. 05). Conclusion The application of hemocoagulase for prevention and treatment of the widened hematoma in patients with hypertensive cerebral hemorrhage is significantly,it helps to significantly improve short&long term curative effect,may not affect platelet,coagulation,liver and kidney functions,and drug safety is high,it is worthy of clinical popularization and application.