目的 探討吡拉西坦聯(lián)合七葉皂苷鈉治療腦出血的臨床療效。方法 選取2014年7月-2016年7月在鹽亭縣人民醫(yī)院進(jìn)行治療的腦出血患者62例，依據(jù)治療方法的不同分為對(duì)照組（31例）和治療組（31例）。對(duì)照組靜脈滴注注射用七葉皂苷鈉，10 mg加入250 mL生理鹽水，2次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注吡拉西坦注射液，8 g加入250 mL生理鹽水，1次/d。兩組患者均治療2周。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者神經(jīng)功能缺損程度評(píng)分（NIHSS）、蒙特利爾認(rèn)知評(píng)估量表（MoCA）、簡(jiǎn)易智力狀態(tài)檢查量表（MMSE）和日常生活能力量表（ADL）以及腦水腫、腦血腫體積和血清學(xué)指標(biāo)變化。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為80.65%、96.77%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，NIHSS顯著降低，MoCA、MMSE和ADL評(píng)分均顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者上述4項(xiàng)評(píng)分均明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組腦水腫和腦血腫體積均顯著減小（P<0.05）；且治療組患者腦水腫和腦血腫體積顯著小于對(duì)照組（P<0.05）。治療后，兩組患者血清NSE、MCP-1、水平均降低，但BDNF水平升高（P<0.05）；且治療組的血清學(xué)指標(biāo)改善優(yōu)于對(duì)照組（P<0.05）。結(jié)論 吡拉西坦聯(lián)合七葉皂苷鈉治療腦出血可有效降低腦水腫和腦血腫體積，有利于神經(jīng)功能和認(rèn)知功能的改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of piracetam combined with sodium aescinate in treatment of cerebral hemorrhage. Methods Patients (62 cases) with cerebral hemorrhage in Yanting People's Hospital from July 2014 to July 2016 were divided into control (31 cases) and treatment (31 cases) groups based on different treatments. Patients in the control group were iv administered with Sodium Aescinate for injection, 10 mg added into normal saline 250 mL, twice daily. Patients in the treatment group were iv administered with Piracetam Injection on the basis of the control group, 8 g added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, clinical efficacy was evaluated, and the change of NIHSS, MoCA, MMSE, and ADL scores, and cerebral edema and cerebral hematoma volume, and serum indicators in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.65% and 96.77%, respectively, and there were differences between two groups (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but MoCA, MMSE, and ADL scores were significantly increased, and the difference was statistically significant in the same group (P<0.05). And these scores in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the cerebral edema and cerebral hematoma volume in two groups was significantly decreased (P<0.05). And the cerebral edema and cerebral hematoma volume in the treatment group was significantly smaller than that in the control group (P<0.05). After treatment, the NSE and MCP-1 levels in two groups were significantly decreased, but BDNF were significantly increased (P<0.05). And these serum indicators in treatment group were significantly better than those in the control group (P<0.05). Conclusion Piracetam combined with sodium aescinate can effectively reduce the cerebral edema and cerebral hematoma volume in treatment of cerebral hemorrhage, and is conducive to the improvement of neurological cognitive function, which has a certain clinical application value.