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1、%臨床薈萃&2010年8月5日第25卷第15期ClinicalFocus,August5,2010,Vol25,No.151311論著早期應(yīng)用水蛭素治療腦出血的臨床研究劉在貴1,程方敏2(1.濱州醫(yī)學(xué)院生物化學(xué)與分子生物學(xué)教研室,山東濱州256603;2.濱州市人民醫(yī)院神經(jīng)內(nèi)科,山東濱州256610)摘要:目的觀察水蛭素注射液對(duì)自發(fā)性腦出血血腫吸收、血腫周圍低密度區(qū)改變及對(duì)神經(jīng)功能恢復(fù)的影響。方法將425例入選的自發(fā)性腦出血患者隨機(jī)分為治療組308例和對(duì)照組117例。治療組給予水蛭素注射液6ml加入5%葡萄糖液250ml
2、中靜脈滴注,每日1次。分別于治療前和治療后4、10、21天利用CT測量血腫體積及血腫周圍低密度區(qū),采用歐洲卒中量表進(jìn)行神經(jīng)功能缺損評(píng)分。結(jié)果治療組第10、21天血腫體積均明顯低于對(duì)照組,(2110)mlvs(278)ml,(147)mlvs(259)ml(P<0.01);治療組21天時(shí)血腫周圍低密度區(qū)小于對(duì)照組,(1.50.4)mmvs(3.00.7)mm(P<0.01);治療組第10、21天歐洲卒中量表神經(jīng)功能缺損評(píng)分(ESS)均明顯高于對(duì)照組,(6219)分vs(4616)分、(6624)分vs(5114)分(P<0
3、.01)。結(jié)論早期應(yīng)用水蛭素注射液能促進(jìn)腦出血血腫的吸收,使血腫周圍低密度區(qū)縮小和促進(jìn)神經(jīng)功能恢復(fù)。關(guān)鍵詞:腦出血;水蛭素類;病例對(duì)照研究中圖分類號(hào):R743.34文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1004583X(2010)15131103ClinicalresearchofearlyapplicationofhirudintherapyoncerebralhemorrhageLIUZaigui1,CHENGFangmin21.DepartmentofBiochemistry,BinzhouMedicalCollege,Binzhou
4、256603,China;2.DepartmentofNeurology,BinzhouMunicipalPeople!sHospitalinShandongProvince,Binzhou256610,ChinaABSTRACT:ObjectiveToinvestigatetheeffectsofhirudinonabsorptionofintracerebralhematoma,changesoflowdensityareasurroundinghematoma,andrecoveryofneurologicalfunctio
5、ninpatientswithspontaneousintracerebralhemorrhage.Methods425patientswithspontaneousintracerebralhemorrhagewererandomlydividedintotreatmentgroupandcontrolgroup,308casesand117casesrespectively.Thepatientsintreatmentgroupwereintravenouslygiventhemixtureofhirudinsolution6m
6、land5%glucose250mloncedaily.ThevolumeofhematomaandlowdensityareaaroundhematomaweremeasuredbyCTbeforeandaftertreatmentat4,10and21days,theneurologicalfunctionwasscoredbytheEuropeanStrokeScale.ResultsHematomavolumeinthetreatmentgroupwassignificantlysmallerthanthatinthecon
7、trolgroupatthe10thand21thdayrespectively,(2110)mlvs(278)ml,(147)mlvs(259)ml(P<0.01).Thelowdensityareaaroundhematomainthetreatmentgroupwassignificantlysmallerthanthatinthecontrolgroup,(1.50.4)mmvs(3.00.7)mm(P<0.01).Theneurologicalfunctionscoreinthetreatmentgroupwassi
8、gnificantlyhigherthanthatinthecontrolgroupat10thand21stdayrespectively,(6219)fractionsvs(4616)fractions,(6624)fract
