安宫牛黄丸联合血肿穿刺抽吸术治疗高血压脑出血的效果及预后影响因素分析  

Effect of Angong Niuhuang Pill Combined with Hematoma Aspiration on Hypertensive Intracerebral Hemorrhage and Influencing Factors of Prognosis

作　　者：党艳娥 万文洲 贾松岩 栗巧杰 DANG Yan’e;WAN Wenzhou;JIA Songyan;LI Qiaojie(Encephalopathy and Hypertension Ward,Zhumadian Traditional Chinese Medicine Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中医院脑病高血压病区,河南驻马店463000

出　　处：《河南医学研究》2023年第22期4157-4161,共5页Henan Medical Research

摘　　要：目的 探讨立体定向血肿穿刺抽吸术联合安宫牛黄丸治疗高血压脑出血的效果及预后影响因素。方法 回顾性分析驻马店市中医院2019年4月至2022年4月收集的150例高血压脑出血患者的临床资料,均进行立体定向血肿穿刺抽吸术联合安宫牛黄丸治疗,分析治疗效果。根据格拉斯哥预后(GOS)评分分为两组,即预后不佳和预后良好,经logistic回归分析影响预后因素。结果 150例患者经治疗后14 d,患者治疗后14 d患者颅内压、颅内血肿体积、美国国立卫生研究院卒中量表(NIHSS)评分低于治疗前,丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、神经生长因子(NGF)改善情况优于治疗前(P<0.05)。经logistic回归分析,年龄≥60岁、出血量>70 mL、血肿破入脑室、一侧或双侧瞳孔散大是影响患者预后的独立因素。结论 安宫牛黄丸治疗立体定向血肿穿刺抽吸术高血压脑出血效果显著,但预后仍受年龄、出血量、瞳孔散大、血肿破入脑室影响,故需针对危险因子,进行相应干预,改善预后。Objective To explore the curative effect of stereotactic hematoma puncture and aspiration combined with Angong Niuhuang pill in the treatment of hypertensive intracerebral hemorrhage and the prognostic factors.Methods A total of 150 patients with hypertensive intracerebral hemorrhage who were retrospectively analyzed were collected from April 2019 to April 2022 in Zhumadian Traditional Chinese Medicine Hospital,and the patients were treated with stereotactic hematoma aspiration combined with Angong Niuhuang pill to analyze the treatment effect.They were divided into poor prognosis and good prognosis according to the Glasgow prognosis(GOS)score,and the factors affecting the prognosis were analyzed by binary logistic regression.Results The intracranial pressure,intracranial hematoma volume and National Institute of Health stroke scale(NIHSS)score of 150 patients were lower than those before treatment 14 days after treatment,and the improvement of malondialdehyde(MDA),nerve growth factor(NGF),glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)were better than those before treatment(P<0.05).According to binary logistic regression analysis,age≥60 years old,bleeding volume>70 mL,hematoma breaking into the ventricle,unilateral or bilateral pupil dilation were independent factors affecting the prognosis of patients.Conclusion Angong Niuhuang pill has a significant effect on hypertensive intracerebral hemorrhage after stereotactic hematoma puncture and aspiration,but the prognosis is still affected by age,bleeding volume,dilated pupils,and hematoma breaking into ventricles.Therefore,it is necessary to carry out corresponding intervention against risk factors to improve the prognosis.

关 键 词：安宫牛黄丸 立体定向血肿穿刺抽吸术 高血压脑出血 预后 影响因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]