| Background: Cerebral hemorrhage is a cerebrovascular disease with high disability rate and high mortality.Hypertension is the most common cause of the disease,and its hematoma prone sites are mostly in the putamen,caudate nucleus and thalamus.Hematoma has not only primary injury but also secondary injury to brain tissue,and brain edema is one of the common secondary injuries.In recent years,studies have shown that glibenclamide can prevent the progress of edema,improve neurological function,and become a hot spot of clinical research.Objective:The purpose of this study was to observe the improvement of neurological function,safety,hypoglycemia and other adverse reactions of glibenclamide combined with conventional medical treatment in intracerebralcerebralhemorrhage（ICH）compared with conventional medical treatment.Methods:A total of 60 patients with primary cerebral hemorrhage in the cardiovascular and cerebrovascular Hospital of the Affiliated Hospital of Yan’an University from November2020 to November 2021 were collected.According to the nanodischarge standard,the eligible patients were randomly divided into the experimental group and the control group.There were 30 patients in the experimental group and 30 patients in the control group.One patient in the experimental group underwent hematoma removal,and one patient with recurrent cerebral hemorrhage broke into the ventricle during the follow-up period.The experimental group was excluded,Therefore,28 cases were included in the experimental group.The experimental group was given glibenclamide 1.25 mg 3 times / day for 7 days.This treatment was based on conventional medical treatment;The control group was also given ICH routine medical treatment.Both groups controlled the high-risk factors of cerebrovascular disease（such as hypertension,smoking history,drinking,hyperlipidemia,etc.）.The improvement of neurological function was compared before treatment,7 days after treatment,14 days after treatment and 3 months after treatment.After admission,all patients underwent head CT and calculated the hematoma volume,evaluated the National Institutes of Health Stroke Scale（NIHSS）,Glasgow comascale（GCS）and modifyrankinscale（MRS）before treatment;After 72 h of treatment,head CT was reexamined（the volume of hematoma was calculated according to Tada formula abc\/2,and the expansion of hematoma was defined as the increase of hematoma volume by more than or equal to 33% or more than 6ml after treatment）;After 7 days of treatment,NIHSS score scale and CT scan were used;After 14 days of treatment,NIHSS scale was used;Mrs score after 3 months of treatment.Results:1.Comparison of baseline data between the experimental group and the control group: a total of 58 cases were enrolled in the study group,28 cases in the experimental group,17 males and 11 females,and 30 cases in the control group,including 15 males and the remaining 15 females.There was no significant difference between the experimental group and the control group in the number of smokers in the past history and personal history of hypertension,hyperlipidemia,diabetes,coronary heart disease and so on.There was no significant difference between the two groups in the baseline data at the time of admission: age,neurological function score scale and cerebral hematoma volume.2.Comparison of NIHSS scores between the experimental group and the control group in the same period: before treatment,7 days after treatment and 14 days after treatment,the results showed that there was no significant difference between the two groups.It showed that glibenclamide combined with conventional medical treatment had no significant difference in the improvement of neurological function compared with conventional medical treatment at the above time points.Mrs scores of the experimental group and the control group were compared at two time points before clinical treatment and three months of treatment respectively.The results showed that the severity of neurological function of the experimental group and the control group were basically similar before clinical treatment.However,after 3 months of treatment,the neurological function of glibenclamide combined with conventional medical treatment group was significantly improved compared with that of conventional medical treatment group.3.Intra group comparison: the NIHSS scores at each monitoring point（7 days and 14days）and the Mrs scores at 3 months in the glibenclamide group before and after treatment are compared,as shown in table 2-3 and table 2-6,p<0.001.The difference between the two monitoring points is statistically significant.It can be seen that the average NIHSS score of glibenclamide combined with conventional medical treatment for primary cerebral hemorrhage is reduced from 10.17 to 6.03,and the average Mrs score is reduced from 3 to 0,showing a gradually decreasing trend,The functional outcome improved significantly.Comparison within the control group: the NIHSS scores and Mrs scores of each monitoring point（7 days and 14 days）and 3 months in the conventional medical treatment group before and after treatment are compared,as shown in table 2-3 and table 2-7 below,p<0.001.The results show that the differences are statistically significant,indicating that the NIHSS score is improved from an average of10.33 to 6.20,the average Mrs score is reduced from 3 to 0,the scores are gradually reduced from high to low,and the functional outcome is improved.4.The hematoma expansion rates of the experimental treatment group and the control treatment group were compared: at the beginning of 72 hours of treatment,the patients in the experimental group and the control group both rechecked the head CT,measured the hematoma volume and compared it with the hematoma volume measured at the time of admission.The data results are shown in table 2-8 below.A total of 1 person in the experimental treatment group had hematoma expansion,with an expansion rate of 0.35%.The number of hematoma expansion in the control treatment group was 3,and the hematoma expansion rate of this group was 1%,There was no significant difference in hematoma enlargement rate between the two groups,indicating that glibenclamide had no significant effect on hematoma enlargement.5.Compare the incidence of adverse drug reactions between the two groups: the results are shown in table 2-9 below.Compared with the treatment of primary basal ganglia intracerebral hemorrhage with glibenclamide combined with conventional medical treatment in the experimental group,the incidence of adverse drug reactions in the two groups is not statistically significant.Conclusion: 1.Glibenclamide combined with routine medical treatment can improve the neurological function of intracerebral hemorrhage for 3 months.There was no significant improvement in neurological function after 14 days.2.There was no significant difference between the experimental group and the conventional medical treatment.3.There was no significant difference in the incidence of hypoglycemia,infection and electrolyte disorder between the experimental group and the control group,and the safety was good. |
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