高血压性单侧基底节区脑出血银杏叶提取物应用时机的研究

发布时间：2018-05-23 23:04

本文选题：高血压性脑出血 + 单侧基底节区　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:对入组的患者进行多重分析比较,探讨改善循环药物银杏叶提取物(EGb761)在高血压性脑出血中的应用时机及评估其安全性,为临床工作中银杏叶提取物在脑出血中的应用时机选择提供理论支持。方法:将2015年6月至2016年9月在山西省人民医院神经内科住院的且符合本研究入组标准的90例单侧基节区高血压性脑出血患者按入院顺序分为试验1组、试验2组和对照组各30例。在入组时完成对所有患者的一般资料记录,包括登记年龄、收缩压、舒张压、体温、入院时血糖、入院延迟时间,并同时收集发病当天头颅CT血肿体积、NIHSS评分等数据。3组皆参照中华医学会于2014年颁布的《中国脑血管病防治指南》指导确定治疗的方案。试验1组在发病后1周加用EGb761注射液70mg静滴1次/日,试验2组发病2周后加用EGb761注射液70mg静滴1次/日,治疗14天,同时进行头颅CT血肿体积、NIHSS评分的数据收集,并分别与入院时头颅CT血肿体积与NIHSS评分做差求得差值,记录3组神经功能缺失评分差值及血肿体积差值。在完成相关数据收集后,以spss17.0统计软件进行数据处理,以方差分析推测组间是否具有差异,采用SNK-q检验进行各组间均数之间的两两全面比较,预设P0.05有统计学意义。结果:1.3组患者入院时的年龄、收缩压与舒张压、即刻血糖值、体温、入院延迟时间经统计分析检验后表明差异无统计学意义具有可比性(P0.05)。2.3组患者颅内血肿体积的差值及NIHSS评分差值行正态性检验和方差齐性检验符合正态分布及方差齐性,经方差分析可知3组患者的血肿体积差值及NIHSS评分差值之间有差异,并具有统计学意义(P0.05)。3.通过对3组患者颅内血肿体积的差值及NIHSS评分差值的两两比较发现对照组与实验1组、对照组与实验2组、实验2组与实验1组患者头颅血肿体积差值及NIHSS评分差值有差别,实验2组患者头颅血肿体积差值及NIHSS评分差值大于对照组,而实验1组患者头颅血肿体积差值及NIHSS评分差值大于实验2组,并具有统计学意义(P0.05)。结论:1.高血压性脑出血后在没有禁忌的情况下可于发病1周后应用EGB761进行治疗,可显著缩短脑出血后血肿的吸收时间,改善神经功能缺损和预后。2.在高血压性脑出血较早期应用EGB761并没有增加颅内再出血及其他不良反应的概率。
[Abstract]:Objective: to study the application of EGb761 in hypertensive intracerebral hemorrhage and to evaluate the safety of EGB 761 in patients with hypertensive intracerebral hemorrhage. To provide theoretical support for the application of Ginkgo biloba extract in cerebral hemorrhage. Methods: from June 2015 to September 2016, 90 patients with hypertensive intracerebral hemorrhage in unilateral basal ganglia who were hospitalized in Department of Neurology, Shanxi Provincial people's Hospital, were divided into two groups according to their admission order. There were 30 cases in test group 2 and 30 cases in control group. Complete general records of all patients at the time of admission, including age of registration, systolic blood pressure, diastolic blood pressure, body temperature, blood glucose at admission, admission delay time, At the same time, the data of NIHSS score of cranial CT hematoma volume and so on were collected on the same day. 3 groups were all in accordance with the guidelines of Chinese Cerebrovascular Disease Prevention and treatment issued by the Chinese Medical Association in 2014 to determine the treatment plan. Group 1 was treated with EGb761 injection 70mg once a day at 1 week after onset, group 2 was treated with EGb761 injection 70mg once a day for 14 days after onset, and the data of head CT hematoma volume and NIHSS score were collected at the same time. The difference between CT hematoma volume and NIHSS score was obtained, and the difference of neurological deficit score and hematoma volume was recorded in three groups. After the completion of the data collection, spss17.0 statistical software for data processing, ANOVA is used to predict whether there is a difference between groups, SNK-q test is used to carry out a comprehensive comparison between the two groups of the average, P05 presupposition has statistical significance. Results the age at admission, systolic and diastolic blood pressure, immediate blood glucose, body temperature, The difference of the volume of intracranial hematoma and the difference of NIHSS score between the two groups were consistent with normal distribution and homogeneity of variance. The variance analysis showed that the difference of hematoma volume and NIHSS score was different among the three groups, and the difference was statistically significant (P0.05. 3). By comparing the volume difference of intracranial hematoma and the difference of NIHSS score between the three groups, it was found that there were differences in the volume difference of cranial hematoma and NIHSS score between the control group and experimental group 1, control group and experimental group 2, experimental group 2 and experimental group 1. The difference in volume of cranial hematoma and NIHSS score in experimental group 2 was higher than that in control group, while the difference in volume of cranial hematoma and NIHSS score in group 1 was higher than that in group 2, and had statistical significance (P 0.05). Conclusion 1. EGB761 can be used in the treatment of hypertensive intracerebral hemorrhage 1 week after the onset without contraindication, which can significantly shorten the time of hematoma absorption, improve the neurological function defect and prognosis. 2. Early application of EGB761 in hypertensive intracerebral hemorrhage did not increase the probability of intracranial rebleeding and other adverse reactions.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.34

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