氨甲环酸保守治疗混杂密度慢性硬膜下血肿的临床观察

发布时间：2019-04-09 16:49

【摘要】：目的探讨口服氨甲环酸对混杂密度慢性硬膜下血肿保守治疗的疗效。方法选取2013年1月至2016年6月就诊于我院的混杂密度慢性硬膜下血肿22例,全组病例均行头颅CT平扫确诊。所有患者均口服氨甲环酸250mg每日3次,治疗1~3月,随访4~6个月。比较患者用药前后血肿量的变化,神经功能恢复情况,观察头颅CT的演变过程。结果有效16例(72.7%),无效4例(18.2%),失访2例(9.1%)。16例(72.7%)在治疗1个月后,头疼、肢体乏力等临床症状均有改善,3个月后临床症状基本消失,头颅CT示血肿明显吸收。3例因口服药物3~4周后临床症状加重收住院行手术治疗,术后继续口服氨甲环酸,随访6个月无1例复发。1例在服药1个月后临床症状明显好转,血肿大部分呈低密度影,血肿吸收减少,后因消化道不适停止服药。2例分别在服药8周及12周后失访。结论口服氨甲环酸保守治疗混杂密度慢性硬膜下血肿安全有效,同时可减少混杂密度CSDH钻孔引流术后复发。
[Abstract]:Objective to evaluate the efficacy of oral carbacycloic acid in the conservative treatment of mixed density chronic subdural hematoma. Methods from January 2013 to June 2016, 22 patients with mixed density chronic subdural hematoma were selected. All patients were diagnosed by head CT plain scan. All patients were treated with 250mg 3 times a day for 1 to 3 months and followed up for 4 months for 6 months. The changes of hematoma volume and the recovery of neurological function were compared before and after treatment, and the evolution of brain CT was observed. Results 16 cases (72.7%) were effective, 4 cases (18.2%) were ineffective, 2 cases (9.1%) were lost follow-up, 16 cases (72.7%) had improved clinical symptoms such as headache and limb fatigue after 1 month treatment. The clinical symptoms disappeared after 3 months and the hematoma was obviously absorbed by CT in the head. 3 cases were admitted to hospital for 3 weeks because of the aggravation of clinical symptoms after 3 weeks of oral medication, and then they continued to take carbaric acid orally after operation. After 6 months of follow-up, no recurrence was found in 1 case, the clinical symptoms were obviously improved after 1 month's treatment, most of the hematoma showed low density shadow, hematoma absorption decreased, and then stopped taking medicine because of digestive tract discomfort. 2 cases lost follow-up after 8 weeks and 12 weeks, respectively. Conclusion it is safe and effective to treat chronic subdural hematoma with mixed density by oral administration of carbacycloic acid. It can also reduce the recurrence of CSDH drainage with mixed density.
【作者单位】：绵竹市人民医院成都医学院附属绵竹医院;
【分类号】：R741

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