舒血寧注射液結(jié)合微創(chuàng)穿刺抽吸術(shù)治療高血壓性腦出血48例臨床觀察

1、舒血寧注射液結(jié)合微創(chuàng)穿刺抽吸術(shù)治療高血壓性腦出血48例臨床觀察         08-05-24 10:14:00     作者：李曉東，安志紅    編輯：studa20【摘要】  目的探討舒血寧注射液結(jié)合微創(chuàng)穿刺抽吸術(shù)治療高血壓性腦出血的臨床療效。方法將48例病人隨機(jī)分為治療組和對(duì)照組，治療組在微創(chuàng)治療及內(nèi)科常規(guī)治療的基礎(chǔ)上于術(shù)后72 h予舒血寧20 ml加入生理鹽水250 ml 靜脈滴注，1次/d，共2周，對(duì)照組微創(chuàng)治療

2、及內(nèi)科常規(guī)治療。結(jié)果兩組治療均能改善患者臨床癥狀，但治療組基本痊愈率明顯提高，而死亡率顯著降低。結(jié)論舒血寧結(jié)合微創(chuàng)穿刺抽吸術(shù)治療高血壓性腦出血療效優(yōu)于單純西醫(yī)對(duì)照組。 【關(guān)鍵詞】  舒血寧注射液； 微創(chuàng)穿刺抽吸術(shù)； 高血壓腦出血Clinical Study on Treatment of Minimally Invasive Surgery Combined with Shuxuening Injection for 48 Cases of Intracranial Hematoma Caused by  Hypertension Cerebral HemorrhageAb

3、stract：ObjectiveTo study the therapeutic efficacy of minimally invasive surgery combined with Shuxuening injection for intracranial hematoma caused by  hypertension  cerebral hemorrhage.Methods48 cases of  ICH  caused by hypertension  cerebral hemorrhage were divided randoml

4、y into two  groups. The control group(24) was treated by minimally invasive surgery combined with conventional medical treatment ,and the treatment group was treated by Shuxuening injection combined with minimally invasive surgery and conventional medical treatment,  the course of treatmen

5、t was 2 weeks for each group.ResultsThe two groups could improve the clinical symptomes of the patients but the basic curative rate in the treatment group was significantly higher than that (33.3%) in the control group(12.5) (P0.05), and  the rate of death significantly decreased . ConclusionTh

6、e Shuxuening injection that in minimally invasive surgery for intracranial hematoma caused by hypertension  cerebral hemorrhage efficacy was higher than combined with that in simple western Medicine group.Key words：Shuxuening injection;  Minimally invasive surgery ;  Intracranial hema

7、toma caused by  hypertension  cerebral hemorrhage    2000年以來(lái)，我院應(yīng)用顱內(nèi)血腫微創(chuàng)穿刺抽吸術(shù)配合中成藥舒血寧注射液及西藥治療高血壓性腦出血48例?，F(xiàn)報(bào)道如下。1  資料與方法1.1  一般資料48 例均為住院病例，隨機(jī)分為微創(chuàng)穿刺抽吸術(shù)合用中西藥組（治療組）、微創(chuàng)穿刺抽吸術(shù)合用西藥組（對(duì)照組）各24例，其性別、年齡、入院時(shí)神經(jīng)功能缺損程度積分、伴發(fā)疾病計(jì)分、既往史積分、出血部位、血腫平均體積、平均血壓等指標(biāo)，經(jīng)統(tǒng)計(jì)學(xué)處理差異均無(wú)顯著性（P0.05）。1.2 診斷標(biāo)準(zhǔn)

8、西醫(yī)診斷標(biāo)準(zhǔn)采用1995 年中華醫(yī)學(xué)會(huì)第4屆腦血管病學(xué)術(shù)會(huì)議制訂的各類(lèi)腦血管疾病診斷要點(diǎn)中高血壓性腦出血的診斷要點(diǎn)。入選病例還應(yīng)具備：發(fā)病后72 h內(nèi)入院，確診為高血壓性腦出血，并經(jīng)CT證實(shí)殼核血腫>20 ml 或已破入腦室，丘腦血腫15 ml 或已破入腦室，小腦血腫>10 ml，皮質(zhì)下血腫30 ml 或有中線明顯移位者，腦室血腫>20 ml，或第3，5 腦室梗塞或以第3 腦室為中心形成腦室內(nèi)外大血腫者；生命體征較穩(wěn)定；依據(jù)改良愛(ài)丁堡-斯堪的納維亞研究評(píng)分標(biāo)準(zhǔn)，所選病例均在2341分之間(含41分者)，即中型偏重與重型患者。中醫(yī)診斷標(biāo)準(zhǔn)按國(guó)家中醫(yī)藥管理局腦病急癥協(xié)作組1996

9、 年制訂的中風(fēng)病中醫(yī)診斷、療效評(píng)定標(biāo)準(zhǔn)（試行）中診斷標(biāo)準(zhǔn)執(zhí)行。1.3  治療方法 治療組在微創(chuàng)治療及內(nèi)科常規(guī)治療(脫水、抗感染、保護(hù)胃黏膜及心腎功能等) 的基礎(chǔ)上于術(shù)后72  h予舒血寧20 ml (銀杏葉提取物， 黑龍江珍寶島藥業(yè) 每支2ml) 加入生理鹽水250 ml 靜脈滴注，1次/d，共2周；對(duì)照組予微創(chuàng)治療及內(nèi)科常規(guī)治療。2  療效觀察2.1  療效標(biāo)準(zhǔn)根據(jù)文獻(xiàn)1 ，神經(jīng)功能缺損評(píng)分減少91%100%，能恢復(fù)工作或操持家務(wù)，病殘程度為0 級(jí)為基本治愈；神經(jīng)功能缺損評(píng)分減少46%90%，生活自理，部分工作，或生活基本自理、部分需人幫助，病殘程度13 級(jí)為顯著進(jìn)步；神經(jīng)功能缺損評(píng)分減少18%45%為進(jìn)步；神經(jīng)功能缺損評(píng)分減少17%左右為無(wú)變化；治療期滿30 d，功能評(píng)分增加18%以上為惡化；及死亡共6 級(jí)。2.2  統(tǒng)計(jì)學(xué)處理采用t檢驗(yàn)及2檢驗(yàn)。