| Intracefebral hemorrhage (ICH) is a kind of disease with high lethality and maim rate. A good deal of animal experiments and clinical trials have demonstrated that neuronal function and prognosis couldn't be improved through clearing hematoma early. Pathological mechanism of ICH included : the compression of hematoma itself, the toxitity of hematoma components and the decrease of cerebral blood flow of perihematoma . Nimodipine could protect neuron and promote the rehabilation of patients through four ways: reducing the ischemical damage of brain through improving vasospasm, anti free radical; anti vessel toxic of thrombase , increasing the energy utility of brain tissue. But there still had no common opinion about the use of nimodipine. The key point is on the time window . This trial was to observe the curative effect and to explore the optimal therapy time of nimodipine at different time .Methods: 40 ICH cases were selected. All patients were confirmed as ICH according to the revised criterion of the 4th cerebral vascular disease conference. The hematoma positions were under tenterioum and the volume of hematoma > 40ml without any other vital diseases. All patients were divided into four groups : three were treatment groups and one was control group . Three treatment groups were used with nimodipine (8mg) intravenously at 121u 48h> 5d respectively(q.d X 15 days). The control group were not treated with nimodipine. All groups were treated with mannitol and ordinary liquid. The2003hematoma volume ,area of edema(according CT), Chinese strke scale(CSS) and Barthel index were detected at 12h, 5d and 15d . The level of neuronal specific enolase (NSE) were determined by radio immunity assay in 5 cases each group at!2h, 48h, 5d, Id, lOd . Results :1. Changes of the volume of hematoma: 1The volume of hematoma of all patients had no change within 5 days and dropped gradually after 5 days.2There had no significant difference between hematoma volume of the 5th day and the primary 12h(p>0.05). 3the volume of hematoma of four groups all shrinked at the 5th day and the 1 5th day compared with that of pre-treatment. There had no significant difference among them(p>0.10).2. Changes of edema area: 1Cerebral edema could be showed at different levels within the primary 12h. Edema area expanded apparently on the 5th day and shrinked gradually from the 5th day to 15th day. The area of the 15th day was larger than that of the primary 12h. 2The changes of edema area which was after therapy compared with that of pre-treatment had significant difference among groups(p<0.01).(3)The expansion scope of edema area on the 5th day: the group of applying nimodipine within 12h expanded 3.65 ±3.26, which was significantly smaller than that of the central group which was 7.13± 4.12(p<0.05). 4The expansion scope of edema area on the 15th day: the groups of applying nimodipine within 12h, at 48h, at 5d expanded 0.26 ± 3.21, 0.58±1.29, 0.91 ± 2.21, which was significantly smaller than that of the central group which was 5.45 ± 3.75(p<0.05).3. Changes of CSS score: 1The CSS mark was the highest after ICH at once and had no change within five days. It took on a declining trend from 5th day to 15th day. 2 The changes of CSS score had significant difference among groups after therapy compared with that pretreatment(P<0.01). 3Comparing the remainder of the CSS mark which the 5th day substract it of pre-therapy: the group applying nimodipine within 12h decreased 1.40±4. 57,but it increased 3.80±4.41 in control group. There had significant difference between them (p<0.05). 甌he declining scope of CSS score on the 15th day compared with that of pretherapy: the groups of applying nimodipine within 12h, at 48h, at 5d expanded 8.00±4.61, 8.00 ± 5.42, 7.40±5.91 respectively, which was significantlylarger than that of the control group which was 0.00±7.13(p<0.05).4. Changes of Barthel index: 1Barthel index took on a rising trend. The trend was not apparent within 5 days and was significant from 5th day to 1 5th day. 2The...
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