吡拉西坦氯化钠注射液治疗脑卒中并颅内高压的临床疗效观察

摘要

Objective To observe the clinical effect of piracetam and sodium chloride injection in treating stroke patients complicated with intracranial hypertension. Methods A total of 80 stroke patients complicated with intracranial hypertension were selected in the people′s Hospital of Yingde from August 2013 to August 2015,and they were divided into control group and study group according to random number table,each of 40 cases. patients of both groups received conventional treatment after admission,and patients of control group were given extra mannitol injection,while patients of study group were given extra piracetam and sodium chloride injection. Clinical effect,intracranial pressure before treatment,decreasing range of intracranial pressure,time for intracranial pressure reached to valley value,duration of intracranial hypertension,incidence of adverse reactions,urine output during treatment and after treatment were compared between the two groups. Results No statistically significant differences of clinical effect was found between the two groups( u = 0. 34,P > 0. 05). No statistically significant differences of intracranial pressure before treatment,decreasing range of intracranial pressure,time for intracranial pressure reached to valley value or duration of intracranial hypertension was found between the two groups( P > 0. 05). No statistically significant differences of urine output during treatment or after treatment was found between the two groups( P >0. 05),urine output after treatment of the two groups were statistically significantly less than those during treatment(P < 0. 05). Some patients of control group occurred mild increase of urea nitrogen and creatinine;no one of the two groups occurred gastrointestinal reactions,bounce of intracranial pressure or fervescence. Conclusion piracetam and sodium chloride injection has clinical effect in treating stroke patients complicated with intracranial hypertension,can effectively reduce the intracranial pressure,adjust the brain tissue metabolism,promote the recovery of brain function,and is safe;it is recommended that piracetam and sodium chloride injection can be served as substitute of mannitol injection for patients with contraindications.%目的：观察吡拉西坦氯化钠注射液治疗脑卒中并颅内高压的临床疗效。方法选取英德市人民医院2013年8月—2015年8月收治的脑卒中并颅内高压患者80例，按照随机数字表法分为研究组和对照组，每组40例。两组患者入院后均给予抗血小板、营养神经、溶栓等常规治疗，研究组患者给予吡拉西坦氯化钠注射液治疗，对照组患者给予甘露醇注射液治疗。比较两组患者的临床疗效、用药前颅内压、降压幅度、颅内压达谷值时间、颅内高压持续时间及不良反应发生情况，治疗期间和治疗后排尿量。结果两组患者临床疗效比较，差异无统计学意义（ u =0.34，P >0.05）。两组患者用药前颅内压、降压幅度、颅内压达谷值时间、颅内高压持续时间比较，差异无统计学意义（P >0.05）。两组患者治疗期间及治疗后排尿量比较，差异无统计学意义（P >0.05）；两组患者治疗后排尿量均少于治疗期间，差异有统计学意义（P <0.05）。对照组患者治疗第5天、第6天出现轻度尿素氮及肌酐水平升高；两组患者治疗期间或治疗后均未出现胃肠道反应、颅内压反跳、体温升高等严重不良反应。结论吡拉西坦氯化钠注射液治疗脑卒中并颅内高压的临床疗效确切，可有效降低颅内高压、改善脑组织代谢、促进脑功能恢复，且无严重不良反应，建议将吡拉西坦氯化钠注射液作为有甘露醇注射液用药禁忌证的脑卒中并颅内高压患者的替代药。