不同剂量地塞米松联合尿激酶冲洗治疗高血压脑出血的疗效及脑保护机制研究  

Effect of different doses of dexamethasone combined with urokinase on hypertensive intracerebral hemorrhage and its brain protection mechanism

作　　者：张虎庭 罗赛华[1] 林涛 邱兵[1] Zhang Huting;Luo Saihua;Lin Tao;Qiu Bing(Department of Neurosurgery,Lianjiang People's Hospital,Zhanjiang,Guangdong 524400,China)

机构地区：[1]广东省廉江市人民医院,广东湛江524400

出　　处：《首都食品与医药》2023年第14期67-69,共3页Capital Food Medicine

摘　　要：目的研究不同剂量地塞米松联合尿激酶冲洗治疗高血压脑出血的疗效及其对脑保护机制的影响。方法选取廉江市人民医院2021年4月-2023年1月诊断为高血压脑出血的患者80例为研究对象,按照等距随机抽样法分为大剂量组、中等剂量组、小剂量组、对照组,每组20例。四组患者入院后均行脑血肿钻孔引流术,术后经三通管反复冲洗脑血肿(地塞米松+尿激酶5万U+生理盐水,共5ml)。小剂量组每次地塞米松用量为1mg,中等剂量组每次地塞米松用量为2.5mg,大剂量组每次地塞米松用量为4mg,对照组不用地塞米松。分别评估四组患者治疗前后血肿清除效果、炎症指标、血流动力学指标。结果四组术后相互比较,使用不同剂量地塞米松的三组在血肿清除效果、炎症指标、血流动力学指标方面均优于对照组(P<0.05),不同剂量地塞米松联合尿激酶各组之间相互比较差异无统计学意义(P>0.05)。结论地塞米松联合尿激酶冲洗治疗高血压脑出血相比单独使用尿激酶效果更好,同时大剂量地塞米松联合尿激酶冲洗相比其他剂量效果较强,但为了避免地塞米松的副作用,临床应用还是以小剂量为宜。Objective To study the effect of different doses of dexamethasone combined with urokinase on hypertensive intracerebral hemorrhage and the influence of brain protection mechanism.Methods 80 patients with hypertensive intracerebral hemorrhage diagnosed by Lianjiang People's Hospital from April 2021 to January 2023 were selected as the study subjects.They were divided into large dose group,medium dose group,small dose group and control group according to the method of equidistant random sampling,with 20 people in each group.Four groups of patients were treated with brain hematoma drilling and drainage after admission,and the brain hematoma was repeatedly flushed through a three-way tube(dexamethasone+urokinase 50000U+normal saline,5ml in total).The dose of dexamethasone in the low-dose group is 1mg each time,the dose of dexamethasone in the middle-dose group is 2.5mg each time,the dose of dexamethasone in the high-dose group is 4mg each time,and the control group does not use dexamethasone.The hematoma clearance effect,inflammatory index and hemodynamic index of the four groups were evaluated before and after treatment.Results The hematoma clearance effect,inflammatory index and hemodynamic index of the other three groups were better than those of the control group(P<0.05).There was no statistically significant difference between the four groups with different doses of dexamethasone combined with urokinase(P>0.05).Conclusion The effect of dexamethasone combined with urokinase rinse solution on hypertensive intracerebral hemorrhage is better than that of urokinase alone.At the same time,the effect of large dose of dexamethasone combined with urokinase rinse solution is stronger than that of other doses,but in order to avoid the side effects of dexamethasone,the clinical application is still appropriate to use small dose.

关 键 词：微创置管术 尿激酶 高血压脑出血 疗效分析 

分 类 号：R722.151[医药卫生—儿科]