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目的:对七叶皂甙钠联合甘露醇治疗放射性脑水肿的临床效果进行研究。方法:对我院2012年1月~2014年5月期间收治的64例因放射治疗所致的脑水肿患者进行资料回顾性分析,将64例患者随机分为对照组和治疗组,每组均为32例。对两组患者均采用浓度为20%的甘露醇1 g/kg,每日两次,静脉滴注;地塞米松每次10mg,每日一次,静脉滴注,两周一个疗程。治疗组在此基础上加用七叶皂甙钠15mg溶于250ml生理盐水,每日一次,静脉滴注,两周一个疗程。然后对两组的临床效果进行对比分析。结果:治疗组32例患者中,显效19例,有效8例,总有效率为84.3%;对照组32例患者中,显效9例,有效11例,总有效率为62.5%。治疗前,治疗组患者的GCS评分(格拉斯哥昏迷评分)与对照组患者的GCS评分,两组之间不存在显著差异。治疗后,治疗组患者的GCS评分和对照组患者的GCS评分,都比治疗前得到了显著改善,而治疗组的效果明显好于对照组,两组存在显著差异,P<0.05;治疗组经治疗后在颅内压、水肿面积及意识障碍方面均有一定的好转,颅内压降低及水肿面积显著减小,明显好于对照组,P<0.05。此外,治疗组的副反应发生率也明显低于对照组。结论:七叶皂甙钠联合甘露醇治疗放射性脑水肿具有非常好的临床效果。
Objective: To study the clinical effect of sodium aescinate combined with mannitol in the treatment of radiation brain edema. Methods: A retrospective analysis of 64 cases of brain edema caused by radiotherapy admitted from January 2012 to May 2014 in our hospital was conducted. 64 patients were randomly divided into control group and treatment group, each group 32 cases. Two groups of patients were used at a concentration of 20% mannitol 1 g / kg, twice a day, intravenous infusion; dexamethasone 10mg, once daily, intravenous infusion, a course of two weeks. On the basis of the treatment group, aescine 15mg was dissolved in 250ml normal saline once a day for two weeks for one course of treatment. Then compare the clinical effects of the two groups. Results: Of the 32 patients in the treatment group, 19 were markedly effective and 8 were effective. The total effective rate was 84.3%. Among the 32 patients in the control group, 9 were markedly effective and 11 were effective. The total effective rate was 62.5%. Before treatment, there was no significant difference between the two groups in the GCS score (Glasgow coma score) in the treatment group and the GCS score in the control group. After treatment, GCS score of the treatment group and GCS score of the control group were significantly improved than before treatment, while the effect of the treatment group was significantly better than the control group, there was significant difference between the two groups, P <0.05; After treatment, there were some improvements in intracranial pressure, edema area and disturbance of consciousness, and the reduction of intracranial pressure and edema area were significantly reduced, which were significantly better than those of the control group (P <0.05). In addition, the incidence of side effects in the treatment group was also significantly lower than the control group. Conclusion: Sodium aescinate combined with mannitol in the treatment of radiation brain edema has a very good clinical effect.