Efficacy of nicardipine combined with intracranial minimally invasive hematoma evacuation in treatment of hypertensive intracerebral hemorrhage
CAO Haibo
WANG Xiaojun
BIAN Jieyong
YU Tao
ZHOU Linqiang
SHI Lei
REN Feng
JIANG Caiqi
GU Yujia
Abstract：Objective To explore the clinical efficacy of nicardipine combined with intracranial minimally inva-sive hematoma evacuation in treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 80 patients with HICH admitted to Suzhou Xiangcheng People's Hospital between May 2020 and May 2024 were divided into the control group(n=40)and the observation group(n=40)according to random number table method.Both groups of patients underwent intracranial minimally invasive hematoma evacuation.After the operation,patients in the control group were treated with nifed-ipine sustained-release tablets to control blood pressure,while those in the observation group were treated with nicardipine injection.The treatment course for both groups was 2 weeks.The therapeutic efficacy after treatment,hemodynamic parame-ters(pulsatility index,resistance index,mean blood flow velocity),stress indexes(serum cortisol,malondialdehyde,superox-ide dismutase)and cerebral nerve function factors(neuron-specific enolase,brain-derived neurotrophic factor,neuropeptide Y)before and after treatment,as well as the scores of Chinese Stroke Scale before treatment and at 1 week and 2 weeks after treatment,and the incidence of adverse reactions in the two groups were compared.Results The total effective rate of the observation group was higher than that in the control group(90.00%(36/40)vs 72.50%(29/40),χ2=4.021,P=0.045).After treatment,the pulsatility index and mean blood flow velocity in the observation group((1.49±0.42)and(72.48±6.54)cm/s,respectively)were both higher than those in the control group((1.31±0.34)and(67.84±5.93)cm/s,respectively),while the resis-tance index of the observation group was lower than that of the control group((1.14±0.47)vs(1.38±0.49)),and the differences were statistically significant(t=2.107,3.324,2.236,all P<0.05).After treatment,the levels of cortisol and malondialdehyde in the observation group((14.26±2.87)μg/dL and(4.21±0.89)nmol/mL,respectively)were lower than those in the control group((16.52±3.02)μg/dL and(5.65±1.02)nmol/mL,respectively),while the level of superoxide dismutase in the observation group was higher than that in the control group((161.54±13.54)U/mL vs(142.45±12.87)U/mL),and the differences were statisti-cally significant(t=3.431,6.728,6.463,all P<0.05).After treatment,the levels of neuron-specific enolase and neuropeptide Y in the observation group((14.56±2.13)ng/mL and(125.85±12.31)pg/mL,respectively)were lower than those in the control group((16.45±2.87)ng/mL and(136.72±14.84)pg/mL,respectively),while the level of brain-derived neurotrophic factor in the observation group was higher than that in the control group((2 540.68±421.63)pg/mL vs(2 270.31±372.51)pg/mL),and the differences were statistically significant(t=3.345,3.566,4.287,all P<0.05).There were statistically significant differences in the intergroup effect,time effect and interaction effect of Chinese Stroke Scale scores between the two groups(Finter-group=11.630,Pinter-group=0.001;Ftime=87.840,Ptime<0.001;Finteraction=5.068,Pinteraction=0.007).At 1 week and 2 weeks after treatment,Chi-nese Stroke Scale scores in the observation group((16.14±5.18)points and(11.32±5.91)points,respectively)were lower than those in the control group((21.23±5.07)points and(15.23±5.12)points,respectively),and the differences were statistically sig-nificant(t=4.441,3.163,both P<0.05).The difference in the incidence of adverse reactions between the observation group and the control group was not statistically significant(15.00%(6/40)vs 17.50%(7/40),χ2=0.092,P>0.05).Conclusion Nicardip-ine combined with intracranial minimally invasive hematoma evacuation has a significant effect for the treatment of HICH,effectively regulating hemodynamics and stress levels,and promoting the recovery of cerebral nerve function,with good safety.
Keywords：nicardipineintracranial minimally invasive hematoma evacuationhypertensive intracerebral hemorrhagecerebral nerve function factorstress levelChinese Stroke Scale score
Publication Date：2025-11-25
Online Publishing Date：2025-12-04(First online date of this platform, not the publication date of the document)
Pages：6( 1350-1355 )