远端缺血适应对自发性脑出血患者的应用效果观察  

Observation of clinical effect of remote ischemic conditioning in patients with spontaneous intracerebral hemorrhage

作　　者：伍琳 孙君昭 韩铖琛 聂幸幸 田宇红 皮红英[4] Wu Lin;Sun Junzhao;Han Chengchen;Nie Xingxing;Tian Yuhong;Pi Hongying(Nursing Department of Chinese PLA Medical School,Beijing 100853,China;Department of Neurosurgery,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China;Department of Otolaryngology Head and Neck Surgery,Medical Department of Otolaryngology,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China;Nursing Education and Research Office,Medical Service Training Center of PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军医学院护理系,北京100853 [2]中国人民解放军总医院第六医学中心神经外科,北京100048 [3]中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部耳外科,北京100048 [4]中国人民解放军总医院卫勤训练中心护理教研室,北京100853

出　　处：《首都医科大学学报》2025年第2期356-362,共7页Journal of Capital Medical University

摘　　要：目的评估远端缺血适应(remote ischemic conditioning,RIC)对自发性脑出血(spontaneous intracerebral hemorrhage,sICH)患者应用的临床效果。方法纳入2023年1月至2024年5月在解放军总医院第六医学中心神经外科确诊并收入院的sICH患者64例作为研究对象。按照组间基线特征匹配的原则,采用计算机随机分组程序分为观察组32例和对照组32例。对照组患者按照《中国脑血管病临床管理指南》进行标准基础用药,观察组在对照组治疗基础上给予RIC治疗,疗程为14 d。比较两组患者入院当天、治疗14 d的美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NHISS)评分和Barthel指数(Barthel index,BI)、计算机断层扫描(computed tomography,CT)影像上血肿体积的变化及不良事件发生率。结果入院时,两组患者的NHISS评分、BI、CT影像血肿体积相比较,差异无统计学意义(P>0.05)。治疗14 d后,观察组、对照组患者NIHSS评分较治疗前均降低,且观察组患者评分低于对照组(P<0.05);两组患者BI均较前升高,观察组患者评分高于对照组(P<0.05);两组患者CT影像血肿体积及不良事件发生率相比较,差异无统计学意义(P>0.05)。结论连续14 d的RIC治疗在sICH患者中应用是安全且耐受性良好的,能够有效改善sICH的神经功能。Objective To evaluate clinical effect of remote ischemic conditioning(RIC)in patients with spontaneous intracerebral hemorrhage(sICH).Methods Sixty-four patients with sICH who were diagnosed and admitted to the Department of Neurosurgery,the Sixth Medical Center of PLA General Hospital from January 2023 to May 2024 were selected as research subjects.Following the principle of matching baseline characteristics between groups,a computerized random grouping program was used to divide them into an observation group of 32 cases and a control group of 32 cases.Patients in the control group received standard basic medication according to the‘Chinese Clinical Management Guidelines for Cerebrovascular Diseases’,while the observation group received RIC treatment in addition to the control groups treatment,with a course of 14 d.The changes in National Institutes of Health Stroke Scale(NIHSS)scores and Barthel index(BI,daily living ability score table)on the day of admission and after 14 d of treatment,the changes in hematoma volume on computed tomography(CT)imaging,and the incidence of adverse events were compared between the two groups.Results At admission,the difference is not statistically significant in NIHSS scores,BI,and CT imaging hematoma volume between the two groups(P>0.05).After 14 d of treatment,the NIHSS scores of both groups were reduced compared to before treatment,and the scores of the observation group were lower than those of the control group(P<0.05);the BI of both groups was increased compared to before,and the scores of the observation group were higher than those of the control group(P<0.05);there were no significant differences in CT imaging hematoma volume and the incidence of adverse events between the two groups(P>0.05).Conclusion Continuous RIC treatment for 14 d is safe and well-tolerated in patients with spontaneous intracerebral hemorrhage and can effectively improve the neurological function of patients.

关 键 词：远端缺血适应 脑出血 神经功能 血肿体积 自发性脑出血 

分 类 号：R743[医药卫生—神经病学与精神病学]