【摘要】：目的探究并分析5%與25%的人血白蛋白對老年性腦出血危重患者血腫與神經(jīng)功能缺損的影響。方法選擇老年性腦出血危重患者95例,按照隨機數(shù)字表法將其分為觀察組和對照組,其中觀察組50例,對照組45例。對照組給予綜合治療(包括甘露醇、呋噻米、甘油果糖等脫水降顱壓治療)和5%人血白蛋白治療,觀察組在對照組綜合治療的基礎(chǔ)上給予25%人血白蛋白治療。治療期間嚴(yán)密檢測患者生命體征,治療前后均對患者進(jìn)行CT檢查、神經(jīng)功能缺損評分、療效評定等操作。結(jié)果兩組患者性別、年齡、出血部位等方面無明顯差異(P0.05),具有可比性。觀察組患者治療前神經(jīng)功能缺損評分為(21.56±7.35)分,對照組患者治療前神經(jīng)功能缺損評分為(20.45±6.32)分,兩組無明顯差異(t=0.712,P0.05)。兩組患者治療4 w后神經(jīng)功能缺損評分分別為(8.67±4.78)分、(13.25±3.42)分,兩組差異(t=4.571,P0.05);兩組患者治療后4 w神經(jīng)功能缺損評分均明顯低于治療前(t=19.92,P0.05;t=8.31,P0.05)。觀察組患者基本痊愈率(34.0%)明顯高于對照組患者(13.3%,P0.05),且觀察組患者總有效率明顯高于對照組(P0.05)。兩組患者治療前顱內(nèi)血腫體積分別為(18.3±8.2)ml、(18.4±7.5)ml(t=0.062,P0.05),二者無明顯差異,治療后兩組患者血腫體積分別為(18.4±7.5)ml、(12.5±3.6)ml,差異顯著(t=5.052,P0.05),且所有患者治療后4 w血腫體積均明顯小于治療前(t=7.39,P0.05;t=4.34,P0.05)。結(jié)論 25%人血白蛋白較5%人血白蛋白更能有效較低顱內(nèi)壓,減輕顱內(nèi)高壓引起的并發(fā)癥,有助于神經(jīng)功能恢復(fù),提高痊愈率。
[Abstract]:Objective to investigate and analyze the effects of 5% and 25% human albumin on hematoma and neurological impairment in elderly patients with intracerebral hemorrhage. Methods 95 patients with severe intracerebral hemorrhage were randomly divided into observation group (n = 50) and control group (n = 45). The control group was treated with comprehensive therapy (including mannitol, furosemide, glycerol fructose and other dehydration and lowering intracranial pressure) and 5% human serum albumin. The observation group was given 25% human serum albumin on the basis of comprehensive treatment in the control group. During the treatment, the vital signs of the patients were closely examined. The patients were examined with CT before and after treatment, the neurological deficit score and the evaluation of curative effect were performed. Results there was no significant difference in sex, age and bleeding location between the two groups (P0.05). The neurological deficit score before treatment was (21.56 鹵7.35) in the observation group and (20.45 鹵6.32) in the control group. There was no significant difference between the two groups (t _ (0.712) P 0.05). The neurological deficit scores of the two groups were (8.67 鹵4.78) and (13.25 鹵3.42) after 4 weeks of treatment, respectively, and the difference between the two groups was significant (P 0.05). The neurological deficit scores in both groups were significantly lower than those before treatment (t = 19.92, P 0.05, P = 8.31, P 0.05). The basic recovery rate of the observation group (34.0%) was significantly higher than that of the control group (13.3g / kg P0.05), and the total effective rate of the observation group was significantly higher than that of the control group (P0.05). The volume of intracranial hematoma in the two groups was (18.3 鹵8.2) ml, (18.4 鹵7.5) ml (t0. 062 ml,) before treatment, and there was no significant difference between the two groups. After treatment, the hematoma volume of the two groups was (18.4 鹵7.5) ml,. (12.5 鹵3.6) ml, was significantly different (P 0.05), and the hematoma volume in all patients was significantly lower than that before treatment (t = 7.39, P 0.05). (P 0.05). Conclusion 25% human serum albumin is more effective than 5% human serum albumin in lowering intracranial pressure, alleviating complications caused by intracranial hypertension, contributing to the recovery of nerve function and increasing recovery rate.
【作者單位】： 上海市第七人民醫(yī)院;
【基金】：上海醫(yī)院藥學(xué)科研基金資助(No.2013-YY-01-02) 上海市第七人民醫(yī)院“七院新星”人才培養(yǎng)項目(No.XX2012-026)
【分類號】：R743.34

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