颅内血肿微创清除术联合中医中药治疗出血性卒中的疗效观察

发布时间：2018-06-21 05:15

本文选题：出血性卒中 + 颅内血肿微创清除术联合中医中药　；参考：《湖北中医药大学》2014年硕士论文

【摘要】：目的：比较出血性卒中（即脑出血ICH）出血量25~60ml的内科保守治疗和6-72h早期颅内血肿微创清除术联合中医中药治疗两种治疗方案，观察脑出血早期颅内血肿微创清除术联合中医中药的临床疗效。方法：以2013年8月至2014年3月期间襄阳市襄州区人民医院神经内科一病区收治的原发性脑出血（ICH）出血量25~60ml患者50例为研究对象，根据严格的纳入标准，遵循知情同意原则，向患者直系家属充分告知内科保守、6-72h早期颅内血肿微创清除术联合中医中药两者各自的利弊，将患者分为颅内血肿微创清除术联合中医中药组（微创联合组）和内科保守治疗组（保守组）。比较两组患者的近期疗效和远期疗效。近期疗效指标为GCS评分，血肿体积，住院期间死亡率，住院天数；远期疗效指标为术后3个月随访的日常生活活动能力（ADL）评分。住院期间相关指标，组间比较采用χ2检验，计量资料采用t检验进行分析。结果：在近期疗效中GCS评分，血肿量，住院时间方面，微创联合组具有更大的优势，住院期间死亡率两组无统计学意义；远期疗效为术后3个月随访的日常生活活动能力（ADL）评分，内科保守治疗组与6-72h早期颅内血肿微创清除术联合中医中药组相比无显著性差异（P0.05）。结论：出血性卒中出血量25~60ml的内科保守治疗和6-72h早期颅内血肿微创清除术联合中医中药在远期疗效方面无明显差异，但结合近期疗效如GCS评分，血肿体积，住院天数等指标，我们认为6-72h早期颅内血肿微创清除术联合中医中药是治疗出血性卒中的一个较好方法。
[Abstract]:Objective: to compare the internal conservative treatment of hemorrhagic apoplexy (ICH) and the minimally invasive excision of intracranial hematoma (ICH) combined with traditional Chinese medicine (TCM) for 6 to 72 hours after intracerebral hemorrhage. To observe the clinical effect of minimally invasive removal of intracranial hematoma in early stage of intracerebral hemorrhage combined with traditional Chinese medicine. Methods: from August 2013 to March 2014, 50 25~60ml patients with primary intracerebral hemorrhage (ICH) in Department of Neurology, Xiangzhou people's Hospital, Xiangyang City, were selected as subjects. According to the strict inclusion criteria, the principle of informed consent was followed. To fully inform the immediate family members of the patients of the advantages and disadvantages of minimally invasive removal of intracranial hematoma in the early period of 6-72 hours of internal medicine combined with traditional Chinese medicine. The patients were divided into two groups: minimally invasive removal of intracranial hematoma combined with traditional Chinese medicine (minimally invasive combined group) and conservative treatment group (conservative group). The short-term and long-term outcomes were compared between the two groups. The short-term curative effect indexes were GCS, hematoma volume, mortality during hospitalization, hospitalization days, and ADL score of daily living activity (ADL) after 3 months follow-up. The relative indexes during hospitalization were analyzed by 蠂 2 test and t test respectively. Results: GCS score, hematoma volume and length of stay in the short-term curative effect, the minimally invasive combined group had more advantages, but there was no significant difference between the two groups in the mortality rate during hospitalization. The long-term curative effect was ADL score after 3 months follow-up. There was no significant difference between the conservative treatment group and the early intracranial hematoma removal group combined with traditional Chinese medicine at 6-72 hours (P 0.05). Conclusion: there is no significant difference in long-term curative effect between conservative treatment of hemorrhagic stroke volume of 25~60ml and minimally invasive removal of intracranial hematoma from 6 to 72 hours in combination with traditional Chinese medicine, but combined with short-term curative effect such as GCS score, hematoma volume, length of stay in hospital and so on. We think that minimally invasive excision of intracranial hematoma in 6-72 hours combined with Chinese medicine is a better method for the treatment of hemorrhagic apoplexy.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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