摘要
目的:探讨高血压脑出血在立体定向软通道微创术后应用中医综合疗法治疗的疗效及对患者神经功能的影响。方法:选取2017年1月至2018年12月上海复旦大学附属中山医院徐汇医院神经外科收治的68例高血压脑出血患者为研究对象,所有患者均在发病后24 h内接受立体定向软通道微创术治疗,术后按随机数字表法分为对照组和观察组,每组34例。对照组接受西医常规治疗,观察组在术后3 d加用中医综合疗法治疗,观察14 d。比较两组神经功能缺损评分、残余血肿量、中医证候评分。随访1~3个月,比较两组临床疗效、术后再出血率、便秘发生率和肢体痉挛发生率。结果:术后1 d和3 d,两组神经功能缺损评分、残余血肿量、中医证候积分比较均无明显差异(均P>0.05);术后7 d与14 d,两组神经功能缺损评分、残余血肿量、中医证候积分均显著下降,且观察组均明显低于对照组(均P<0.05);观察组治疗总有效率为91.18%,显著高于对照组的70.59%(P<0.05)。观察组术后再出血率、便秘发生率和肢体痉挛发生率均显著低于对照组(均P<0.05)。结论:高血压脑出血立体定向软通道微创术后采用中医综合疗法治疗可获得显著疗效,可促进患者神经功能改善,有利于残余血肿量的吸收,值得临床推广。
Objective:To investigate the curative effect of traditional Chinese medicine(TCM)combined therapy on hypertensive intracerebral hemorrhage(HICH)after stereotactic soft channel minimally invasive surgery and its effect on neurological function.Methods:68 HICH patients in our hospital from January 2017 to December 2018 were selected.All patients received stereotactic soft channel minimally invasive surgery within 24 h after onset.After operation,the patients were randomly divided into a control group and an observation group,with 34 cases in each group.The patients in the control group received conventional western medicine treatment,and those in the observation group additionally received traditional Chinese medicine 3 days after operation.The course of treatment was 14 days.The clinical efficacy,postoperative rebleeding rate,incidence of constipation and limb spasm,neurological deficit score,residual hematoma volume and TCM syndrome score were compared.Results:There was no significant difference in neurological deficit score,residual hematoma volume and TCM syndrome score between the two groups on the 1st and 3rd day after operation(P>0.05).On the 7th and 14th days after operation,the neurological deficit score,residual hematoma volume and TCM syndrome score of the two groups decreased significantly(P<0.05),and the changes were more marked in the observation group(P<0.05).The total effective rate of the observation group was 91.18%,which was higher than that of the control group(70.59%)(P<0.05).The incidence of rebleeding,constipation and limb spasm in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:After stereotactic soft channel minimally invasive surgery for HICH,TCM combined therapy could obtain remarkable curative effect,and it could improve the neurological function and enhance the absorption of residual hematoma.
作者
卢贤贵
孙树杰
张晓丹
董茜
王治瑜
Lu Xiangui;Sun Shujie;Zhang Xiaodan;Dong qian;Wang Zhiyu(Department of Neurosurgery,Xuhui Hospital,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China)
出处
《广西医科大学学报》
CAS
2019年第12期1999-2002,共4页
Journal of Guangxi Medical University
关键词
高血压脑出血
立体定向软通道微创术
中医综合疗法
临床疗效
hypertensive intracerebral hemorrhage
stereotactic soft channel minimally invasive surgery
comprehensive treatment of traditional Chinese medicine
curative effect
