活血醒脑汤对慢性硬膜下血肿患者术后血肿清除及预后的影响
2018,50(2):16-20
摘要：目的：观察活血醒脑汤对慢性硬膜下血肿患者术后血肿清除率及预后的影响。方法：将慢性硬膜下血肿采用钻孔置管引流术治疗的患者70例按治疗方式不同分为2组各35例。对照组进行基础治疗联合常规西药治疗；观察组在对照组治疗方案的基础上应用活血醒脑汤治疗。术后2月，比较2组神经功能缺损疗效、血肿清除率、硬膜下血肿残余量、日常生活活动能力（ADL）以及并发症发生情况。结果：2组神经功能缺损疗效比较，总有效率观察组94.29%，对照组74.29%，2组总有效率比较，差异有统计学意义（P＜0.05）。2组血肿清除率比较，总有效率观察组91.43%，对照组71.43%，2组比较，差异有统计学意义（P＜0.05）。2组硬膜下血肿残余量情况比较，术后30天、60天，2组硬膜下血肿残余量均呈下降趋势，且观察组硬膜下血肿残余量均低于对照组，组间比较，差异均有统计学意义（P＜0.05）。2组ADL评分比较，术后30天、60天，2组ADL评分呈上升趋势，且观察组ADL评分均高于对照组，组间比较，差异均有统计学意义（P＜0.05）。观察组硬膜下积液、继发性颅内血肿等发生率均低于对照组，差异均有统计学意义（P＜0.05）；对照组张力性气颅、死亡等发生率高于对观察组，但组间比较差异均无统计学意义（P＞0.05）。结论：慢性硬膜下血肿患者运用活血醒脑汤治疗，能有效提高血肿清除率，减少血肿残余量，促进神经功能恢复，提高患者日常生活活动能力，减少并发症发生率，在临床中具有运用价值。
关键词：慢性硬膜下血肿；活血醒脑汤；血肿清除；血肿残余量；生活质量评分；川芎嗪；头孢曲松钠
Effect of Huoxue Xingnao Tang on Postoperative Hematoma Clearance and Prognosis of Patients with Chronic Subdural Hematoma
Abstract：Objective：To observe the effect of Huoxue Xingnao tang on postoperative hematoma clearance rate and prognosis of patients with chronic subdural hematoma.MethodsAccording to different treatment modality，divided 70 cases of patients with chronic subdural hematoma who
receivedtreatment of trepanation and drainage indwelling into two groups，35 cases in each group.Control group received basic treatment combined with routine western medicine therapy，while observation group was additionally treated with Huoxue Xingnao tang.After two months of treatment，compared curative effect of neurologic impairment，hematoma clearance rate，residual subdural hematoma，activities of daily living(ADL)，and incidence of complication of both groups.ResultsCompared curative effect of neurologic impairment in two groups，the total effective rate was 94.29%in the observation group and was 74.29%in the control group，the difference being significant(P＜0.05).Compared the hematoma clearance rate of both groups，the total effective rate was 91.43%in the observation group and was 71.43%in the control group，the difference being significant(P ＜ 0.05).Compared the residual subdural hematoma，downtrend were showed in both groups in the 30thand 60thday after operation，and the residual amount in the observation group were all lower than those in the control group，differences being significant in the intergroup comparison(P＜0.05).Compared the ADL score in both groups，there was a rising trend in the 30thand 60thday after operation，and the ADL score in the observation group was all higher than that in the control group，differences being significant in the intergroup comparison(P＜0.05).Incidence of subdural effusion and secondary intracranial hematoma in the observation group were all lower than those in the control group，differences being significant(P＜0.05).Incidence of tension pneumocephalus and death rate of the control group were higher than those of the observation group，but no significant difference being found in the intergroup com-parison(P＞0.05).ConclusionThe application of Huoxue Xingnao tang for patients with chronic subdural hematoma can evidently improve the hematoma clearance rate，reduce the residual of hematoma，promote recovery of neural functional，and improve the activities of daily living of patients as well as reduce the incidence of complication，which is worth of clinical application.
Key words：Chronic subdural hematoma；Huoxue Xingnao tang；Hematoma clearance；Residual of hematoma；Activities of daily living；Tetramethylpyrazine；Ceftriaxone sodium
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基金项目：甘肃省自然科学基金资助项目(15RJZA096)
