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中华脑科疾病与康复杂志(电子版) ›› 2021, Vol. 11 ›› Issue (04) : 204 -208. doi: 10.3877/cma.j.issn.2095-123X.2021.04.004

脑科疾病与康复

贝伐单抗治疗难治性脑水肿临床效果研究
程龙阳1, 李韶雅1, 陈春雷1, 王娟1, 徐曼曼1, 代海滨1, 赵鹏来1,()   
  1. 1. 210008 南京,南京大学医学院附属鼓楼医院神经外科
  • 收稿日期:2021-08-11 出版日期:2021-08-15
  • 通信作者: 赵鹏来
  • 基金资助:
    南京市卫生青年人才培养工程(QRX17084)

Clinical study of bevacizumab in the treatment of refractory cerebral edema

Longyang Cheng1, Shaoya Li1, Chunlei Chen1, Juan Wang1, Manman Xu1, Haibin Dai1, Penglai Zhao1,()   

  1. 1. Department of Neurosurgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2021-08-11 Published:2021-08-15
  • Corresponding author: Penglai Zhao
引用本文:

程龙阳, 李韶雅, 陈春雷, 王娟, 徐曼曼, 代海滨, 赵鹏来. 贝伐单抗治疗难治性脑水肿临床效果研究[J]. 中华脑科疾病与康复杂志(电子版), 2021, 11(04): 204-208.

Longyang Cheng, Shaoya Li, Chunlei Chen, Juan Wang, Manman Xu, Haibin Dai, Penglai Zhao. Clinical study of bevacizumab in the treatment of refractory cerebral edema[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2021, 11(04): 204-208.

目的

观察贝伐单抗治疗难治性脑水肿的临床效果。

方法

选择南京大学医学院附属鼓楼医院神经外科重症监护病房自2020年7月至2021年6月收治的8例经常规脱水和激素等处理1周后仍表现为难治性脑水肿患者为研究对象。所有患者予以贝伐单抗200 mg,于无菌技术下采用生理盐水250 mL稀释至0.8 mg/mL,持续静脉滴注维持90 min以上。比较患者用药前后脑水肿量及GCS评分改善情况。

结果

对于难治性脑水肿患者,贝伐单抗可明显改善脑水肿,用药后2 d影像学检查提示脑水肿较前改善;用药1周后测量脑水肿量较用药前缓解,GCS评分高于用药前。

结论

贝伐单抗治疗神经外科难治性脑水肿效果显著,可减轻脑水肿,改善患者临床预后。

Objective

To observe the clinical effect of bevacizumab in the treatment of refractory brain edema.

Methods

Eight patients with refractory brain edema who were treated with regular dehydration and hormone for one week in the neurosurgical intensive care unit of Neurosurgery Department of Nanjin Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from July 2020 to June 2021 were selected as the research objects. All patients were given bevacizumab 200 mg, diluted to 0.8 mg/mL with 250 mL normal saline under sterile technology, and continued intravenous drip for more than 90 min. The amount of brain edema and the improvement of GCS score were compared before and after treatment.

Results

For patients with refractory brain edema, bevacizumab could significantly improve brain edema. Imaging examination showed that brain edema was improved 2 d after treatment. The amount of brain edema measured 1 week after treatment of all patients were relieved compared with that before treatment, and the GCS score of all patients were higher than that before treatment.

Conclusion

Bevacizumab is effective in the treatment of neurosurgical refractory brain edema, which can reduce brain edema and improve the clinical prognosis.

表1 患者基本情况及用药前脑水肿体积
图1 大面积脑梗死患者治疗前后头颅CT图
图2 缺血血氧性脑病患者治疗前后头颅CT图
图3 胶质瘤术后患者治疗前后头颅CT图
表2 患者基本情况及用药后脑水肿体积
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