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目的观察创伤性蛛网膜下腔出血用于尼莫地平注射液联合参附注射液的临床疗效。方法将84例创伤性蛛网膜下腔出血患者随机分为对照组与试验组,每组42例。对照组给予尼莫地平注射液20 mg,qd,静脉滴注;试验组在对照组的基础上给予参附注射液30 mL+5%葡萄糖注射液250 m L,bid,静脉滴注。2组均连续用药14 d。比较2组患者的临床疗效、炎症因子水平、凝血功能及药物不良反应发生情况。结果治疗后,试验组预后良好率为69.05%(29/42例),对照组为47.62%(20/42例),差异有统计学意义(P<0.05)。试验组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、凝血酶原时间、部分凝血活酶时间分别为(0.85±0.11)μg·L~(-1),(0.57±0.07)μg·L~(-1),(12.40±1.66)s,(33.75±3.88)s,对照组分别为(1.06±0.15)μg·L~(-1),(1.06±0.13)μg·L~(-1),(14.69±1.63)s,(36.69±4.44)s,差异均有统计学意义(P<0.05)。对照组出现脑梗死4例,脑积水2例,脑出血6例,脑血管痉挛6例,药物不良反应率为42.86%(18/42例);试验组出现脑梗死和脑积水各1例,脑出血和脑血管痉挛各2例,药物不良反应率为14.28%(6/42例),差异有统计学意义(P<0.05)。结论尼莫地平注射液联合参附注射液用于创伤性蛛网膜下腔出血的临床效果较好,能够利于患者预后,改善炎症反应及凝血功能。
Objective To observe the clinical efficacy of traumatic subarachnoid hemorrhage for nimodipine injection combined with Shenfu injection. Methods Totally 84 patients with traumatic subarachnoid hemorrhage were randomly divided into control group and experimental group, with 42 cases in each group. The control group was given nimodipine injection 20 mg, qd, intravenous drip; the experimental group was given Shenfu injection 30 ml + 5% glucose injection 250 m L on the basis of the control group, bid, intravenous drip. The two groups were treated for 14 days. The clinical efficacy, levels of inflammatory cytokines, coagulation and adverse drug reactions in two groups were compared. Results After treatment, the good prognosis of the experimental group was 69.05% (29/42 cases) and that of the control group was 47.62% (20/42 cases), the difference was statistically significant (P <0.05). The time of IL-6, TNF-α, prothrombin, and partial thromboplastin in the experimental group were (0.85 ± 0.11) μg · L -1, (1.07 ± 0.07) μg · L -1, (12.40 ± 1.66) s and (33.75 ± 3.88) s respectively in the control group and (1.06 ± 0.15) μg · L -1 and (1.06 ± 0.13) ) μg · L -1, (14.69 ± 1.63) s and (36.69 ± 4.44) s, respectively. There were significant differences between the two groups (P <0.05). In the control group, 4 cases of cerebral infarction, 2 cases of hydrocephalus, 6 cases of cerebral hemorrhage, 6 cases of cerebral vasospasm, adverse drug reaction rate was 42.86% (18/42 cases); cerebral infarction and hydrocephalus Two cases were found of cerebral hemorrhage and cerebral vasospasm respectively. The rate of ADR was 14.28% (6/42 cases), the difference was statistically significant (P <0.05). Conclusion Nimodipine injection combined with Shenfu injection for traumatic subarachnoid hemorrhage has a good clinical effect, which can benefit the prognosis of patients and improve the inflammatory reaction and coagulation function.