目的 觀察銀杏葉提取物注射液聯(lián)合依達(dá)拉奉注射液治療急性腦出血的臨床療效。方法 收集上海市浦東新區(qū)周浦醫(yī)院2013年7月—2015年7月住院急診腦出血患者82例,隨機(jī)分為對(duì)照組和治療組,每組各41例。對(duì)照組靜脈滴注依達(dá)拉奉注射液,30 mg加入生理鹽水250 mL中,2次/d。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注銀杏葉提取物注射液,17.5 mg加入0.9%氯化鈉注射液500 mL中,1次/d。兩組患者均連續(xù)治療14 d。觀察兩組的臨床療效,并在治療前及治療7、14 d,檢測(cè)NO和SOD水平,計(jì)算水腫體積和血腫體積,比較治療前及治療后1個(gè)月兩組的中國(guó)腦卒中臨床神經(jīng)功能缺損程度評(píng)分量表(CSS)評(píng)分。結(jié)果 治療后,對(duì)照組總有效率為90.24%,治療組總有效率為95.12%,兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組血清NO水平、SOD水平、水腫體積、血腫體積均得到改善,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。經(jīng)過7、14 d治療后,治療組患者血清NO水平均顯著低于對(duì)照組(P<0.05);經(jīng)過7 d治療后,治療組患者血清SOD水平顯著低于對(duì)照組(P<0.05),而經(jīng)過14 d治療后,治療組患者血清SOD水平與對(duì)照組無(wú)統(tǒng)計(jì)學(xué)差異。治療后,治療組患者水腫的治療效果顯著優(yōu)于對(duì)照組(P<0.05),血腫體積迅速減少,治療效果顯著優(yōu)于對(duì)照組(P<0.05)。治療后,兩組患者CSS評(píng)分均較治療前顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組CSS評(píng)分降低程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 銀杏葉提取物注射液聯(lián)合依達(dá)拉奉注射液治療急性腦出血具有較好的臨床療效,清除自由基,改善微循環(huán),有利于患者神經(jīng)功能的恢復(fù),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the effect of Extract of Ginkgo biloba Leaves Injection combined with Edaravone Injection in treatment of intracerebral hemorrhage. Methods Patients (82 cases) with intracerebral hemorrhage in Shanghai Pudong New District Zhoupu Hospital from July 2013 to July 2015 were randomly divided into control and treatment groups, and each group had 41 cases. The patients in the control group were iv administered with Edaravone Injection, 30 mg added into normal saline 250 mL, twice daily. The patients in the treatment group were iv administered with Extract of Ginkgo biloba Leaves Injection on the basis of control group, 17.5 mg added into 0.9% NaCl Injection 500 mL, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the levels of NO and SOD in two groups were determined before treatment and 7 and 14 d after treatment. The volumes of edema and the volume of hematoma were calculated. CSS scores in two groups before treatment and one month after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 90.24% and 95.12%, respectively, and there were differences between two groups (P< 0.05). After treatment, the levels of NO and SOD, and the volumes of edema and the volume of hematoma in two groups were significantly improved, and the difference was statistically significant in the same group (P< 0.05). After treatment for 7 and 14 d, the levels of NO in the control group were significantly lower than those of the treatment group (P< 0.05). After treatment for 7 d, the levels of SOD in the control group were significantly lower than those of the treatment group (P< 0.05), but there was no statistically significant difference between the control group and the treatment group after treatment for 14 d. After treatment, the volumes of edema and the volume of hematoma in the treatment group were significantly lower than those in the control group (P< 0.05). After treatment, CSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). Conclusion Extract of Ginkgo biloba Leaves Injection combined with Edaravone Injection has clinical curative effect in treatment of intracerebral hemorrhage, and can scavenge free radicals, improve microcirculation, and be beneficial for the recovery of neurological function in patients, which has a certain clinical application value.