| Objective: To observe the hypertension cerebral hemorrhage (hypertensive cerebralhemorrhage, HICH) patients during the treatment of plasma D dimer (D-dimer, DD orDDI) levels in patients with hypertensive cerebral hemorrhage, study of D two in theplasma dimer changes in patients with neurological deficits of the relationship between.1,The Research Object:Selection from2010September to2011September in neurosurgery department ofAffiliated Hospital of Yan’an University with hypertensive cerebral hemorrhage of60cases, age from38to78years, mean57.5±12.80years, male27, female33cases. Fromthe onset of symptoms to admission time of3-16h, mean7.4±4.3h.The cause ofhemorrhage: hypertensive cerebral hemorrhage. Have a history of hypertension2-28oradmission blood pressure>140/90mmHg (1mmHg=0.133KPa).At the time of admissionblood pressure110-180/80-100mmHg36cases,181-220/101-120mmHg19cases,≥221/121mmHg5cases. Heart rate <60/min4cases,60-100/min45cases,101-140/min in11cases. Respiratory <15/min2cases,16-20/min46cases.21-35/min12cases. Conscious16cases. lethargy12cases,coma32cases. The study of line operationin treatment of exclusion range. The score of CCS0-15in13cases,24cases of16-30,23cases of31-45. According to the patients with hemorrhage were divided into three groups,the volume of cerebral hemorrhage and10ml in7cases,10-30ml38cases,≥30ml15cases.Cerebral hemorrhage in11cases,49cases were broken into ventricles. Anothersame physical examination center in our hospital health examination in40cases of thecontrol (the control group).There were18male,22female,age55.20±15.30years.Without hypertension, diabetes, atrial fibrillation, liver and kidney disease and bloodcoagulation, recent January were not used on platelet and coagulation factor activity of drugs, and informed consent for testing.2, Eexperimental Method:All patients admitted to the hospital after giving routine physical,neurologicalexamination,and laboratory examination.Within24hours of the condition changes agiven review head CT.Supratentorial hemorrhage was more than30ml,infratentorialhemorrhage than10ml detailed account of the patient’s condition to patients and theirfamilies,according to patients and their families to choose operation or conservativetreatment.Hemorrhage with rupture into ventricle and ventricular casting formation inpatients given line operation or cranium ventricle drainage. Brainstem hemorrhage withconservative treatment,the group all have excluded patients with operation and conecranial intraventricular drainage.Patients admitted to the hospital after conventional give oxygen, vital signs and bloodoxygen saturation monitoring, elevate head of bed10-15oand prevent complicationtreatment.Drug treatment of routine dehydration to reduce intracranial pressure,hemostatic,nerve nutrition,improving cerebral metabolism,blood pressure control,maintenance of water and electrolyte balance and symptomatic treatment.All patients at the first days, third days, seventh days, fourteenth days, test D-dimerlevel.At admission and the incidence of nerve function defect assessment conducted afterJanuary, observed by CT and bleeding, whether or not broken into ventricles.Results: theintracerebral hemorrhage group D-dimer level (1.62±0.54) and control group(0.46±0.27) as compared with statistical significance (P <0.05).Cerebral hemorrhagein women can be seen in the incidence was higher than that in male. D-dimer levels inpatients after onset of (1.62±0.54) and control group (0.46±0.27) as compared toimmediately began to increase, to third days (2.65±1.28) reached the peak,thendecreased gradually, to fourteenth days decreased compared with the control group, nosignificant difference (P>0.05). Significant progress in group (1.17±0.13) andprogressive group (1.41±0.34) as compared with statistical significance (P<0.05);progress group (1.36±0.21) and no change group (1.64±0.27) as compared with statistical significance (P<0.05); no change group (1.64±0.27) and deteriorated groups(1.73±0.32) as compared with statistical significance (P<0.05); deterioration group(1.73±0.32) and death group (1.87±0.45) showed no statistically significant (P>0.05);At the same time also can be drawn in patients with bleeding volume of concentrateddistribution to the L group, accounted for55%. Description of cerebral hemorrhage oftenlarger. No change group is associated with a poor prognosis group (deterioration+deathgroup) in this group of patients was accounted for33%, explain the overall poorprognosis in cerebral hemorrhage. In addition to see difference rate with D dimerizationof two decreases. The curative effects of the patients with statistical analysis, we foundthat the recovery of neurological function in patients with often incomplete, it mostly inno change, deterioration, the death group. The cerebral hemorrhage with high mortality,high disability rate. And death in patients with massive hemorrhage group concentratedon the.Conclusion: HICH in plasma in acute phase of D-dimer level compared with thenormal population increased two; D dimer levels in patients with differential rate,prognostic. |
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