| Objective Spontaneous cerebral hemorrhage(ICH)is a common stroke with high mortality,high disability rate and poor clinical prognosis.In addition to surgery,dehydration to reduce cranial pressure,blood pressure management,brain protection and other treatments,there is no other effective special treatment.Animal experiments and ALIAS experiments have shown that human serum albumin(ALB)can improve the prognosis of stroke and has a neuroprotective effect.In this study,ICH patients were selected as the research objects,and the clinical prognosis of patients was evaluated by modified Rankin score(MRS),and the effect of ALB on the prognosis of ICH patients was observed,so as to provide a theoretical basis for the clinical rescue and treatment of severe ICH patients.Methods A total of 296 patients with supratentorial ICH confirmed by cranial CT/MRI examination admitted to Northern Jiangsu People’s Hospital from August 2018 to September 2020 were continuously collected.According to the NIHSS score,all patients were divided into the non-critical group(NIHSS < 15)of 100 cases and the critical group(NIHSS > 15)of 196 cases.The critical patients were divided into the ALB treatment group of 102 cases and the non-ALB treatment group of 94 cases according to the evaluation and recommendation of physicians and the opinions of patients or their family members.The patients were treated with standard medical treatment,such as dewatering to reduce cranial pressure,nourishing nerves,controlling blood pressure and protecting organs.The ALB group received 20% ALB50 ml intravenous drip once daily for 5 to 7days in addition to standard care.The general clinical data of the patients at admission were collected,including gender,age,history of hypertension,and Glasgow(GCS)score at admission.The amount of cerebral hemorrhage was calculated by using the Tada formula.The next morning,10 m L of venous blood was extracted on an fasting basis,and the indexes of blood routine,blood coagulation routine,liver and kidney function of the patients were detected.MRS score and Barthel index(BI)were used to evaluate the prognosis of patients at 30 days and 90 days.A MRS score of 0-2 was defined as a good prognosis.The hospitalization days,hospitalization costs,endotracheal intubation rate during hospitalization,ICU rescue rate,pulmonary infection rate,and the incidence of neurological symptoms aggravation were compared among the three groups,and the rates of rebleeding,readmissions and other vascular events after 90 days of telephone followup were compared among the three groups.Results 1.In the non-critical group,92 patients(92%)had good prognosis at 30 days,74patients(72.5%)in the ALB group,and 66 patients(70.2%)in the non-ALB group;Compared with the non-critical group,the rate of good prognosis in the non-ALB group was lower(P < 0.05),the ALB group was lower(P < 0.05),and the non-ALB group was similar to the ALB group(P BBB 0 0.05).At 90 days,95 patients(95%)in the non-critical group,88 patients(86.3%)in the ALB group and 74 patients(78.7%)in the non-ALB group had a good prognosis.Compared with the non-critical group,the rate of good prognosis in the non-ALB group was lower(P < 0.05),the ALB group was lower(P < 0.05),but the ALB group was higher than the non-ALB group(P < 0.05).2.The average length of hospital stay was 17 days in the non-critical group,21 days in the ALB group,and 24 days in the non-ALB group;Compared with the non-critical group,the hospital stay of the non-ALB group was longer(P < 0.05)and the ALB group was longer(P < 0.05),but the ALB group was shorter than the non-ALB group(P < 0.05).The average hospitalization cost was 28,400 yuan in the non-critical group,53,100 yuan in the ALB group,and 46,100 yuan in the non-ALB group.Compared with non-critical group,ALB group had higher cost(P < 0.05)and non-ALB group had higher cost(P <0.05).The rate of endotracheal intubation was 0,the rate of ICU rescue was 2(2%),the rate of pulmonary infection was 8(8%),the rate of urinary tract infection was 3(3%)and the rate of symptom aggravation was 2(2.0%)in the non-critical group during hospitalization.In the ALB group,the rate of tracheal intubation was 5(4.9%),the rate of ICU rescue was 6(5.9%),the rate of pulmonary infection was 12(11.7%),the rate of urinary tract infection was 5(4.9%),and the rate of symptom aggravation was 3(2.9%).In the non-ALB group,the rate of endotracheal intubation was 8(8.5%),the rate of ICU rescue was 11(11.7%),the rate of pulmonary infection was 26(27.6%),the rate of urinary tract infection was 12(12.7%),and the rate of symptom aggravation was 10(10.6%).Compared with the non-critical group,the non-ALB group had more tracheal intubation rate,ICU rescue rate,pulmonary infection rate,urinary tract infection rate and symptom aggravation rate(P < 0.05),and the ALB group had more(P < 0.05),but the ALB group was less than the non-ALB group(P < 0.05).3.At discharge,the blood loss,lymphocyte count,albumin and APTT of the non-critical group were 10.01 m L,1.34(10^12/L),38.01(g/L),and 32.32(s),while those of the ALB group were 14.65 m L,lymphocyte count,39.76(g/L),and APTT of the ALB group were 35.79(s).In the nonALB group,the blood loss,lymphocyte count,albumin and APTT were 17.81 m L,1.78(10^12/L),31.72(g/L)and 31.88(s)respectively.Compared with the non-critical group,the non-ALB group had more blood loss,lymphocyte number,and lower albumin and APTT(P < 0.05),while the ALB group had lower blood loss,lymphocyte number,and higher albumin and APTT(P < 0.05).4.On admission,the blood loss in the non-critical group was 28.03 ml,NIHSS was 8,the blood loss in the ALB group was 38.37 ml,NIHSS was 25,and the blood loss in the non-ALB group was 37.37 ml,NIHSS was 23.Compared with the non-critical group,the blood loss and NIHSS in the ALB group and non-ALB group were significantly higher than those in the non-critical group(P < 0.05).Conclusion 1.ALB can improve the functional prognosis of patients with severe ICH,reduce the average length of hospital stay,and reduce the incidence of endotracheal intubation rate,ICU rescue rate,pulmonary infection,urinary tract infection,and aggravation of neurological symptoms during hospitalization.2.ALB can increase the level of APTT and albumin,and reduce blood loss and lymphocyte level. |
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