乌拉地尔联合甘露醇治疗高血压性脑出血的临床效果分析  

Analysis of clinical effect of urapidil combined with mannitol in the treatment of hypertensive intracerebral hemorrhage

作　　者：刘德山 林佩强 郑峥[1] 汪银洲[1] LIU De-shan;LIN Pei-qiang;ZHENG Zheng(Department of Neurology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院神经内科,350001

出　　处：《中国现代药物应用》2023年第19期67-70,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨乌拉地尔联合甘露醇治疗高血压性脑出血(HICH)的作用评价。方法 200例HICH患者,随机分为对照组和观察组,每组100例。对照组使用甘露醇治疗,观察组使用乌拉地尔联合甘露醇治疗。比较两组临床疗效,治疗30、60、90、120 min的血压指标[收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)],治疗前及治疗2、4周的脑血肿量、水肿量、神经功能指标[美国国立卫生研究院卒中量表(NIHSS)评分、改良Barthel指数评定量表(MBI)评分]。结果 观察组治疗总有效率为94.00%,明显高于对照组的75.00%,差异具有统计学意义(P<0.05)。治疗30、60、90、120 min后,观察组的SBP、DBP、MAP均低于对照组,差异具有统计学意义(P<0.05)。治疗2周后,观察组的脑血肿量及脑水肿量分别为(14.65±3.79)、(11.79±4.53)ml,对照组分别为(18.22±4.01)、(17.62±4.97)ml;治疗4周后,观察组的脑血肿量及脑水肿量分别为(5.83±2.34)、(8.02±2.75)ml,对照组分别为(9.50±3.12)、(11.36±3.38)ml。治疗2、4周后,观察组的脑血肿量及脑水肿量均少于对照组,差异具有统计学意义(P<0.05)。治疗2周后,观察组的NIHSS评分、MBI评分分别为(10.35±2.87)、(60.94±7.71)分,对照组分别为(13.16±3.03)、(51.46±8.02)分;治疗4周后,观察组的NIHSS评分、MBI评分分别为(7.02±2.68)、(75.32±8.26)分,对照组分别为(10.97±2.84)、(62.87±8.64)分。治疗2、4周后,观察组的NIHSS评分明显低于对照组, MBI评分明显高于对照组,差异具有统计学意义(P<0.05)。结论 乌拉地尔联合甘露醇治疗HICH效果显著,能快速降压,促进脑血肿及脑水肿的吸收,提高神经功能恢复效果,改善预后。Objective To discuss the role of urapidil combined with mannitol in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 200 patients with HICH were randomly divided into control group and observation group,with 100 cases in each group.The control group was treated with mannitol,and the observation group was treated with urapidil and mannitol.Both groups were compared in terms of clinical efficacy,blood pressure indexes[systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)]after 30,60,90 and 120 min of treatment,volume of cerebral hematoma and cerebral edema,and neurological function indicators[National Institutes of Health Stroke Scale(NIHSS)score,modified Barthel index(MBI)score]before treatment and after 2 and 4 weeks of treatment.Results The total effective rate of the observation group was 94.00%,which was significantly higher than that of 75.00%of the control group,and the difference was statistically significant(P<0.05).After 30,60,90 and 120 min of treatment,SBP,DBP and MAP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 2 weeks of treatment,the volume of cerebral hematoma and cerebral edema in the observation group were(14.65±3.79)and(11.79±4.53)ml,and those in the control group were(18.22±4.01)and(17.62±4.97)ml,respectively.After 4 weeks of treatment,the volume of cerebral hematoma and cerebral edema in the observation group were(5.83±2.34)and(8.02±2.75)ml,and those in the control group were(9.50±3.12)and(11.36±3.38)ml,respectively.After 2 and 4 weeks of treatment,the volume of cerebral hematoma and cerebral edema in the observation group was lower than those in the control group,and the differences were statistically significant(P<0.05).After 2 weeks of treatment,NIHSS score and MBI score in the observation group were(10.35±2.87)and(60.94±7.71)points,and those in the control group were(13.16±3.03)and(51.46±8.02)points,respectively.After 4 weeks of

关 键 词：高血压性脑出血 乌拉地尔 甘露醇 效果 血压 

分 类 号：R544.1[医药卫生—心血管疾病] R743.34[医药卫生—内科学]