中西医结合法治疗慢性硬膜下血肿钻孔引流术后残留血肿的效果分析  

Analysis of the effect of integrated traditional Chinese and western medicine in the treatment of residual hematoma after drilling and drainage of chronic subdural hematoma

作　　者：周告生 邱琳峰 梁邦华 刘志文 谢家金 ZHOU Gaosheng;QIU Linfeng;LIANG Banghua;LIU Zhiwen;XIE Jiajin(Department of Surgery,Ruijin Hospital of Traditional Chinese Medicine,Jiangxi Province,Ruijin342500,China)

机构地区：[1]江西省瑞金市中医院外科,江西瑞金342500

出　　处：《中国当代医药》2025年第5期80-83,87,共5页China Modern Medicine

基　　金：江西省中医药管理局科技计划项目(2023B0023)。

摘　　要：目的探讨中西医结合法治疗慢性硬膜下血肿钻孔引流术后残留血肿的效果。方法选取2022年1月至2023年1月瑞金市中医院收治的62例慢性硬膜下血肿钻孔引流术后残留血肿的患者作为研究对象,按照计算机随机数字表法分为观察组、对照组,每组各31例。对照组单纯口服阿托伐他汀钙片治疗,观察组联合血府逐瘀汤、阿托伐他汀钙片治疗。比较两组的术后残留血肿变化情况、治疗总有效率、神经因子水平。结果观察组术后1、3、6个月的残留血肿量均少于对照组,差异有统计学意义(P<0.05);观察组的总有效率高于对照组,差异有统计学意义(P<0.05);观察组术后6个月的胶质源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)水平均高于对照组,血清神经元特异性烯醇化酶(NSE)、血管内皮生长因子(VEGF)水平均低于对照组,差异有统计学意义(P<0.05)。结论针对慢性硬膜下血肿钻孔引流术后残留血肿患者采用中西医结合法治疗,有利于促进术后残留血肿量的吸收,并改善术后症状和神经功能,值得临床深入研究。Objective To explore the effect of integrated traditional Chinese and western medicine in the treatment of residual hematoma after drilling and drainage of chronic subdural hematoma.Methods A total of 62 patients with residual hematoma after drilling and drainage of chronic subdural hematoma admitted to Ruijin Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the research objects.According to the computer random number method,they were divided into observation group and control group,with 31 cases in each group.The control group was treated with Atorvastatin Calcium Tablets alone,and the observation group was treated with Xuefu Zhuyu Decoction combined with Atorvastatin Calcium Tablets.The changes of residual hematoma,the total effective rate of treatment and the levels of nerve factors were compared between the two groups after operation.Results The residual hematoma volume of the observation group were less than those of the control group at 1,3 and 6 months after operation,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The levels of glial cell-derived neurotrophic factor(GDNF)and brain-derived neurotrophic factor(BDNF)in the observation group were higher than those in the control group 6 months after operation,and the levels of neuron-specific enolase(NSE)and vascular endothelial growth factor(VEGF)were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Integrated traditional Chinese and western medicine treatment for patients with residual hematoma after trephination and drainage of chronic subdural hematoma is beneficial to promote the absorption of residual hematoma after operation,and improve postoperative symptoms and neurological function,which is worthy of clinical research.

关 键 词：慢性硬膜下血肿 钻孔引流术 中西医结合治疗 残留血肿 神经因子 

分 类 号：R651.1[医药卫生—外科学]