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目的:探讨抑肽酶治疗脑出血脑水肿的作用机制。方法:92例高血压脑出血病例随机分为治疗组与对照组。对照组给予20%甘露醇常规减轻脑水肿治疗,治疗组在对照组治疗基础上加用抑肽酶,观察2组疗效和血肿吸收情况。结果:治疗组基本治愈率为77%,明显高于对照组的45%(P<0·05);治疗组各部位血肿全部吸收率为69%,明显优于对照组的45%(P<0·05)。结论:抑肽酶通过对激肽释放酶和激肽级联系统的抑制作用,减少凝血酶的产生和对血肿局部凝血酶的拮抗作用,从而达到促进水肿和血肿吸收作用。
Objective: To explore the mechanism of aprotinin treatment of cerebral hemorrhage in cerebral edema. Methods: 92 cases of hypertensive cerebral hemorrhage were randomly divided into treatment group and control group. The control group was given 20% mannitol routinely to reduce cerebral edema. The treatment group was treated with aprotinin on the basis of the control group, and the curative effect and hematoma absorption of the two groups were observed. Results: The cure rate of the treatment group was 77%, which was significantly higher than that of the control group (P <0.05). The total absorption rate of the hematoma in the treatment group was 69%, which was obviously better than 45% of the control group (P < 0 · 05). CONCLUSION: Aprotinin can promote edema and hematoma absorption by inhibiting the kallikrein and kinin cascade system, reducing the production of thrombin and antagonizing local thrombin in hematoma.