复方甘露醇联合综合干预对高血压脑出血术后患者神经功能及炎性状态的影响  

Effects of compound mannitol combined with a comprehensive intervention on the neurological functions and inflammatory state of postoperative patients with hypertensive intracerebral hemorrhage

作　　者：丁美兰 杜宁娜[2] 张骆骆 张赟[1] DING Meilan;DU Ningna;ZHANG Luoluo;ZHANG Yun(Department of Neurosurgery,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210029,China;Department of Acupuncture and Rehabilitation,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210029,China;Department of Neurosurgery,Nanjing Brain Hospital,Nanjing210029,China)

机构地区：[1]江苏省中医院神经外科,南京210029 [2]江苏省中医院针灸康复科,南京210029 [3]南京市脑科医院神经外科,南京210029

出　　处：《长春中医药大学学报》2021年第6期1411-1414,共4页Journal of Changchun University of Chinese Medicine

基　　金：江苏省中医药局科技项目(YB201801)。

摘　　要：目的探讨复方甘露醇联合综合干预对高血压脑出血术后患者神经功能及炎性状态的影响。方法 2017年5月-2020年5月我院收治的86例高血压脑出血患者,以随机数字表法分为试验组和对照组,各43例。对照组给予小骨窗微创血肿清除术进行治疗,试验组给予小骨窗微创血肿清除术联合复方甘露醇注射液进行治疗,2组治疗周期均为1周,且治疗期间2组均给予综合干预。比较2组治疗后的疗效;治疗前后的神经、肢体、认知功能、血肿大小、水肿体积及血清炎性因子水平。结果治疗后,试验组总有效率高于对照组(93.02% vs 74.42%,P<0.05)。治疗后,2组血清超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及美国国立卫生研究院卒中量表(NIHSS)评分较治疗前降低,且试验组低于对照组(P<0.05);血肿大小、水肿体积较治疗前减小,且试验组较对照组减小更明显(P<0.05);而Fugl-Meyer运动功能评估量表(FMAS)、蒙特利尔认知评估量表(MoCA)评分较治疗前升高,且试验组高于对照组(P<0.05)。结论复方甘露醇联合综合干预可明显改善高血压脑出血术后患者神经、肢体及认知功能,并能减小血肿大小及水肿体积,进而有助于改善机体炎性状态,提高疗效。Objective To investigate the effects of compound mannitol combined with a comprehensive intervention on the neurological functions and inflammatory state of postoperative patients with hypertensive intracerebral hemorrhage.Methods From May 2017 to May 2020,86 patients with hypertensive intracerebral hemorrhage treated in our hospital were randomly divided into an experimental group and a control group,with 43 cases in each group.The control group was treated with the small bone window minimally invasive hematoma removal,while the experimental group was treated with the same method combined with compound mannitol injections.The treatment period of both groups was one week,and both groups were given a comprehensive intervention at the same time.The curative effects of the two groups after treatment,the neurological,limb and cognitive functions,hematoma size,edema volume and serum inflammatory factor levels of the two groups before and after treatment were compared.Results After treatment,the total effective rate of the experimental group was higher than that of the control group(93.02%vs 74.42%,P<0.05).After treatment,the levels of serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and the National Institutes of Health Stroke Scale(NIHSS)scores in the two groups were decreased,and the experimental group was decreased more than the control group(P<0.05).The hematoma size and edema volume were decreased compared with before treatment,and the experimental group was more significantly decreased than the control group(P<0.05),while the scores of the Fugl-Meyer Motor Function Assessment Scale(FMAS)and Montreal Cognitive Assessment Scale(MoCA)were higher in the experimental group than those in the control group(P<0.05).Conclusion Compound mannitol combined with the comprehensive intervention can significantly improve the neurological,limb and cognitive functions of patients after hypertensive intracerebral hemorrhage operation,and can reduce the hematoma size and edema vo

关 键 词：高血压 脑出血 复方甘露醇 综合干预 神经功能 炎症 

分 类 号：R473.6[医药卫生—护理学]