论文部分内容阅读
【目的】观察立体定向微创手术联合中药醒脑活血利水法治疗重症桥脑出血的临床疗效。【方法】将21例患者随机分为治疗组和对照组2组。治疗组10例采用立体定向置管抽吸、引流手术配合醒脑活血利水法中药(由丹参、川芎、赤芍、桃仁、红花、益母草、川牛膝、茯苓、白芷、冰片等组成)以及西医常规治疗,对照组11例采用西医常规保守治疗。【结果】治疗组10例手术均获成功,无手术死亡病例。术后因多脏器功能衰竭死亡1例,肺部感染死亡1例,存活8例,死亡率为20%。随访6个月,格拉斯哥预后评分(GOS)评定5分2例、4分3例、3分1例、2分2例、1分2例。对照组11例患者中存活1例,随访3个月后死亡,其余病例均于发病后14d内死亡,格拉斯哥预后评分(GOS)评定1分11例。治疗组清醒时间和清醒率均优于对照组,且并发症发生率显著低于对照组(均P<0.01)。【结论】采用立体定向微创穿刺引流血肿结合中医醒脑活血利水法治疗重症桥脑出血安全可靠,疗效满意。
【Objective】 To observe the curative effect of stereotactic minimally invasive surgery combined with Chinese medicine activating brain and activating blood circulation to treat severe pontine hemorrhage. 【Methods】 Twenty-one patients were randomly divided into treatment group and control group. In the treatment group, 10 cases were treated with stereotactic catheterization and drainage surgery combined with Chinese herbal medicine for activating brain and activating blood and diuresis (composed of Salvia, Chuanxiong, Radix Paeoniae Alba, Peach kernel, Safflower, Motherwort, Achyranthes, Poria, Angelica, borneolum, etc) Western conventional treatment, control group, 11 cases of conventional conservative treatment of Western medicine. 【Results】 All the 10 cases in the treatment group were successfully operated without any surgical death. One patient died of multiple organ failure, one patient died of lung infection, and 8 patients survived. The mortality rate was 20%. The follow-up 6 months, Glasgow prognostic score (GOS) assessed 5 points in 2 cases, 4 points in 3 cases, 3 points in 1 case, 2 points in 2 cases and 1 point in 2 cases. One of the 11 patients survived in the control group and died after 3 months of follow-up. The rest of the patients died within 14 days after the onset of disease. The Glasgow Outcome Rating (GOS) score was 1 in 11 cases. The awake time and awakening rate of the treatment group were better than those of the control group, and the complication rate was significantly lower than that of the control group (all P <0.01). 【Conclusion】 Stereotactic minimally invasive puncture and hematoma drainage combined with Chinese medicine, refreshing brain and promoting blood circulation and water treatment is safe and reliable, and the curative effect is satisfactory.