建瓴汤联合腰池引流治疗自发性脑出血脑室铸型的效果  

Effect of Jianling Decoction Combined With Lumbar Cisterna Drainage on Ventricular Casting of Spontaneous Intracerebral Hemorrhage

作　　者：杨太生 张俊龙 陈明攀 许英祥 YANG Taisheng;ZHANG Junlong;CHEN Mingpan;XU Yingxiang(Department of Craniocerebral Surgery,Yangjiang Hospital of Traditional Chinese Medicine,Yangjiang Guangdong 529500,China)

机构地区：[1]阳江市中医医院颅脑外科,广东阳江529500

出　　处：《中国卫生标准管理》2023年第22期149-152,共4页China Health Standard Management

基　　金：广东省中医药局科研项目(20232209)。

摘　　要：目的探讨建瓴汤联合腰池引流治疗自发性脑出血(spontaneous intracerebral hemorrhage,sICH)脑室铸型患者的临床效果。方法选择2019年6月—2023年6月阳江市中医医院入院24 h内行微创双侧脑室外引流的56例s ICH脑室铸型患者,按照随机数字表法分为对照组与治疗组,各28例。对照组术后常规给予脱水、尿激酶注药、预防血管痉挛、控制血压等治疗;治疗组在对照组的基础上,术后第3~14天开展腰椎穿刺术释放脑脊液治疗,同时术后第3天起予口服建瓴汤。疗程结束后比较两组干预前(术后3 d)、干预后(4个疗程结束时)格拉斯哥昏迷量表(Glasgow coma scale,GCS)、脑血肿与水肿情况,疗程结束后比较两组格拉斯哥预后量表(Glasgow outcome scale,GOS)、疗效情况。结果干预前两组GCS评分比较,差异无统计学意义(P>0.05);干预后两组GCS评分均高于干预前,且治疗组高于对照组,差异有统计学意义(P<0.05);治疗组干预后GOS分级情况优于对照组,差异有统计学意义(P<0.05);两组干预前脑血肿、水肿体积比较,差异无统计学意义(P>0.05);干预后两组脑血肿、水肿体积均低于干预前,且治疗组低于对照组,差异有统计学意义(P<0.05);治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。结论建瓴汤联合腰池引流治疗s ICH脑室铸型患者疗效显著,能有效改善患者预后。Objective To investigated the clinical effect of Jianling decoction combined with lumbar cisternae drainage in the treatment of patients with spontaneous intracerebral hemorrhage(sICH)ventricle casting.Methods A total of 56 sICH ventricular cast patients admitted to Yangjiang Hospital of Traditional Chinese Medicine from June 2019 to June 2023 who underwent minimally invasive bilateral external ventricular drainage within 24 h were selected.The patients were divided into control group and treatment group accorded to random number table method,with 28 cases in each group.The control group was treated with dehydration,urokinase injection,vasospasm prevention and blood pressure control.On the basis of the control group,the treatment group was treated with lumbar puncture to release cerebrospinal fluid from 3 to 14 days after surgery,and Jianling decoction was taken orally from 3 days after surgery.After the treatment,the Glasgow coma scale(GCS),cerebral hematoma and edema of the two groups were compared before intervention(3 days after surgery)and after intervention(at the end of 4 courses).Glasgow outcome scale(GOS)and curative effect were compared between the two groups after treatment.Results Before intervention,there was no significant difference in GCS scores between the two groups(P>0.05).After intervention,GCS scores of the two groups were higher than before intervention,and the treatment group was higher than the control group,the difference was statistically significant(P<0.05).GOS grading in the treatment group was better than that in the control group after intervention,the difference was statistically significant(P<0.05).There was no statistically significant difference in the volume of pre-intervention hematoma and edema between the two groups(P>0.05).The volume of pre-intervention hematoma and edema between the two groups was lower than that before intervention,and the treatment group was lower than the control group,the difference was statistically significant(P<0.05).The total effective rate of the t

关 键 词：建瓴汤 自发性脑出血 脑室铸型 腰池引流 格拉斯哥昏迷量表 格拉斯哥预后量表 

分 类 号：R255[医药卫生—中医内科学]