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中国临床研究英文版:2018,31(9):1182-1184,1189
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超早期微创术联合药物治疗高血压脑出血
(定州市人民医院神经外二科,河北 保定 073000)
Ultra-early minimally invasive surgery combined with medication in the treatment of hypertensive cerebral hemorrhage
(Second Department of Neurology, Dingzhou City People's Hospital, Baoding, Hebei 073000, China)
摘要
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Received:March 09, 2018   Published Online:September 20, 2018
中文摘要: 目的 探究超早期微创术联合药物治疗高血压脑出血的临床价值,进而为临床高血压脑出血治疗提供借鉴。方法 选择2016年10月至2017年10月收治的90例高血压脑出血患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组45例。对照组患者实施常规治疗方案(常规微创手术、常规西药治疗),观察组患者实施超早期中西医结合治疗方案(超早期微创手术、常规西药治疗、中成药治疗)。两组患者均进行8周的治疗,比较两组患者临床治疗效果,同时观察两组患者治疗前后血肿体积大小、神经功能缺损评分(NDS)、日常生活能力(ADL)以及并发症发生情况。结果 观察组患者的临床治疗总有效率显著高于对照组(73.33 % vs 51.11%,χ2=4.727,P<0.05)。两组患者治疗前的血肿体积、NDS及ADL比较差异无统计学意义(P>0.05)。治疗后,两组患者的血肿体积、NDS及ADL均有所改善,且观察组明显优于对照组(t=12.374、13.259、7.009,P<0.01)。研究组并发症发生率明显低于对照组(37.78% vs 80.00%,χ2=16.568,P<0.01)。结论 在高血压脑出血临床治疗中实施超早期微创术联合药物治疗方案具有良好的临床效果,能够促进血肿吸收,提高神经功能及生活能力,减少并发症的发生,同时有效降低死亡率和伤残率。
Abstract:Objective To explore the clinical value of ultra-early minimally invasive surgery combined with medication in the treatment of hypertensive intracerebral hemorrhage and provide reference in the clinical treatment. Methods Ninety patients with hypertensive intracerebral hemorrhage treated from October 2016 to October 2017 were selected and divided into observation group and control group by random number table method(n=45, each). The routine treatment including routine minimally invasive surgery and routine Western medicine therapy was given in control group, and ultra-early minimally invasive surgery combined imtegrative Chinese and Western medicine was performed in observation group. The clinical effects were compared between two groups after treatment for 8 weeks. At the same time, the size of hematoma, the neurological deficit score (NDS), activity of daily living (ADL) before and after treatment and the incidence of complications were observed in two groups. Results The total effective rate in observation group was significantly higher than that in control group (73.33% vs 51.11%, χ2=4.727, P<0.05). There were no obvious differences in volume of hematoma, NDS and ADL between two groups before treatment (P>0.05). The hematoma volume, scores of NDS and ADL were improved in both two groups and was significantly better in observation group than those in control group (t=12.374, 13.259, 7.009, respectively, P<0.05). The incidence of complications in observation group was statistically lower than that in control group (37.78% vs 80.00%, χ2=16.568, P<0.05). Conclusion Ultra-early minimally invasive surgery combined with drug therapy in the treatment of hypertensive intracerebral hemorrhage has a good clinical effect that manifests in promoting hematoma absorption, improving nerve function and life ability and reducing the incidence of complications. At the same time, the mortality rate and disability rate can be effectively reduced.
文章编号:     中图分类号:R 743.34    文献标志码:A
基金项目:2017年度河北省医学科学研究重点课题计划项目(20171503)
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