醒脑静辅助立体定向软通道引流术在高血压脑出血中的效果观察

doi:10.3760/cma.j.cn441417-20240809-02020

摘要/Abstract

摘要：

目的　观察高血压脑出血患者应用醒脑静注射液辅助立体定向软通道引流术的治疗效果。方法　选取北京中医药大学东直门医院洛阳医院2022年8月至2024年6月收治的高血压脑出血患者84例，按治疗方法不同分为常规组、观察组。常规组41例，男23例、女18例，年龄（62.85±4.06）岁，脑出血病程（4.41±1.23）h，出血量（58.85±5.36）ml；观察组43例，男22例、女21例，年龄（63.21±3.27）岁，脑出血病程（4.68±1.33）h，出血量（59.42±4.76）ml。两组均行立体定向软通道引流术，常规组辅以常规治疗，观察组在常规组的基础上加用醒脑静注射液治疗，均持续治疗2周。比较两组临床疗效，治疗前后的日常生活能力（ADL）、美国国立卫生研究院脑卒中量表（NIHSS）、血流高速峰值（Vm）、收缩期峰值血流速（Vs）、血流阻力指数（RI）、神经肽Y（NPY）、神经元特异性烯醇化酶（NSE）、胶质纤维酸性蛋白（GFAP）、S100钙结合蛋白B（S100B）水平及治疗期间的安全性。采用t检验、χ²检验进行统计分析。结果　观察组总有效率［93.02%（40/43）］高于常规组［75.61%（31/41）］（χ²=4.865，P=0.027）。治疗后观察组ADL评分［（82.16±7.52）分］高于常规组［（68.85±10.26）分］，NIHSS评分［（11.28±4.06）分］低于常规组［（18.74±5.23）分］（均P<0.001）。治疗后观察组、常规组的Vm、Vs水平均高于治疗前，且观察组高于常规组（均P<0.001）；治疗后观察组、常规组的RI、NPY、NSE、GFAP、S100B水平均低于治疗前，且观察组低于常规组（均P<0.001）；两组不良反应总发生率差异无统计学意义（P>0.05）。结论　醒脑静注射液辅助立体定向软通道引流术能提高高血压脑出血患者的疗效，促进神经功能恢复，增强患者自理力，改善脑血流动力学，减轻脑损伤，且具有一定安全性。

关键词:

高血压脑出血, 醒脑静注射液, 立体定向软通道引流术, 神经功能, 脑血流动力学

Abstract:

Objective　To observe the effect of stereotactic soft channel drainage assisted by Xingnaojing injection in the treatment of patients with hypertensive intracerebral hemorrhage. Methods　Eighty-four patients with hypertensive intracerebral hemorrhage treated at Luoyang Hospital, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine from August 2022 to June 2024 were divided into a conventional group (41 cases) and an observation group (43 cases) according to the treatment methods. The conventional group had 23 males and 18 females; they were (62.85±4.06) years old; their duration of intracerebral hemorrhage was (4.41±1.23) hours; the volume of hemorrhage was (58.85±5.36) ml. The observation group had 22 males and 21 females; they were (63.21±3.27) years old; their duration of intracerebral hemorrhage was (4.68±1.33) hours; the volume of hemorrhage was (59.42±4.76) ml. Both groups underwent stereotactic soft channel drainage; the conventional group took conventional treatment; the observation group took conventional treatment and inravenously dripped Xingnaojing injection. Both groups were treated for 2 weeks. The clinical efficacies, scores of activities of daily living (ADL) and National Institutes of Health Stroke Scale (NIHSS), peak blood flow velocities (Vm), peak systolic blood flow velocities (Vs), blood flow resistance (RI), and levels of neuropeptide Y (NPY), neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), and S100 calcium-binding protein B (S100B) before and after the treatment, and safety during the treatment were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The total effective rate of the observation group was higher than that of the conventional group [93.02% (40/43) vs. 75.61% (31/41); χ²=4.865; P=0.027]. After the treatment, the scores of ADL and NIHSS in the observation group were better than those in the conventional group (82.16±7.52 vs. 68.85±10.26 and 11.28±4.06 vs. 18.74±5.23; both P<0.001). After the treatment, the Vm and Vs were higher than those before the treatment in both group, and the Vm and Vs in the observation group were higher than those in the conventional group (all P<0.001). After the treatment, the RI and levels of NPY, NSE, GFAP, and S100B were lower than those before the treatment, and the those in the observation group were lower than those in the conventional group (all P<0.001). There was no statistical difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Stereotactic soft channel drainage assisted by Xingnaojing injection for patients with hypertensive intracerebral hemorrhage can improve the therapeutic effect, promote their neurological function recovery, enhance their self-care ability, improve their cerebral hemodynamics, and reduce their brain damage, and is safe.

Key words:

Hypertensive intracerebral hemorrhage, Xingnaojing injection, Stereotactic soft channel drainage, Neurological function, Cerebral hemodynamics

骆慧武许耀伟古瑞航杨柳.

醒脑静辅助立体定向软通道引流术在高血压脑出血中的效果观察 [J]. 国际医药卫生导报, 2025, 31(2): 279-283.

Luo Huiwu, Xu Yaowei, Gu Ruihang, Yang Liu.

Effect of stereotactic soft channel drainage assisted by Xingnaojing in treatment of patients with hypertensive cerebral hemorrhage [J]. International Medicine and Health Guidance News, 2025, 31(2): 279-283.

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