醒脑静干预对幕上脑出血患者预后及连续脑电图的影响
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R743.34

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Intervention of Xingnao jing Injection Has Effect on Prognosis and Continuous Electroence phalogram in Patients with Supraten to rial Intracerebral Hemorrhage
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    摘要:

    目的:观察醒脑静治疗幕上脑出血对患者脑电图(EEG)及预后的影响,并分析连续脑电图(CEEG)变化情况与幕上脑出血患者预后的关系。方法:将76例幕上脑出血患者按格拉斯哥昏迷评分(GCS)评分轻度障碍类、中度障碍类、重度障碍类分层后随机分为治疗组、对照组各38例,对照组予西医常规内科综合治疗;治疗组在对照组治疗的基础上加用醒脑静注射液静脉滴注10天,所有患者均于入院后24 h内及10天后行CEEG检查,于脑出血患者发病后3月或患者死亡时进行预后统计,比较2组治疗前后CEEG变化及预后情况;并根据所有患者CEEG疗效情况,将其分为CEEG有效组(显著改善+改善)、CEEG无效组(无改善+恶化),分析CEEG变化情况与幕上脑出血患者预后的关系。结果:CEEG疗效比较:整体上看,治疗组轻度、中度障碍患者CEEG改善好于对照组,但差异无统计学意义(P>0.05);重度障碍患者中治疗组CEEG改善明显优于对照组(P<0.05);各类患者CEEG显著改善率、总改善率的比较中,除治疗组中度障碍患者CEEG总改善率优于于对照组(P<0.05)外,其余各类患者显著改善率、总改善率的组间比较,差异均无统计学意义(P>0.05)。预后比较:整体上治疗组患者预后情况显著优于对照组(P<0.05);各类患者预后良好率、死亡率比较,除治疗组中度障碍患者预后良好率优于对照组(P<0.05)外,其余各类患者预后良好率、死亡率的组间比较,差异均无统计学意义(P>0.05)。CEEG疗效与预后关系分析:整体上CEEG有效组预后优于CEEG无效组(P<0.05);在轻度障碍患者中,CEEG有效组死亡率低于CEEG无效组(P<0.05),而良好率组间比较无统计学意义(P>0.05);中度障碍患者中,CEEG有效组良好率高于CEEG无效组(P<0.05)、死亡率低于CEEG无效组(P<0.05);重度障碍患者中,CEEG有效组良好率高于CEEG无效组(P<0.05),而死亡率组间比较无统计学差异(P>0.05)。结论:CEEG对幕上脑出血患者的预后预计颇具应用价值,醒脑静干预对幕上脑出血患者的CEEG及预后改善疗效显著,尤其对中度障碍患者效果较好。

    Abstract:

    Objective: To observe the effect of Xingnaojing injection on electroencephalogram(EEG)and prognosis in treating patients with supratentorial intracerebral hemorrhage,and analyzed the relationship between changes of continuous electroencephalogram(CEEG)and the prognosis of patients with supratentorial intracerebral hemorrhage.Methods:Stratified 76 cases of patients with supratentorial intracerebral hemorrhage according to the mild-impairment type,the moderate-impairment type and the severe-impairment type in Glasgowcoma scale(GCS),and divided theminto the treatment group and the control group randomly,38 cases in each group.The control group was given the routine comprehensive physical treatment in western medicine,while the treatment group additionally received intravenous drip with Xingnaojing injection for 10 days.All the patients received the CEEG examination after hospitalization within 24 h and for 10 days,the statistical analysis of prognosis was conducted after the onset of supratentorial intracerebral hemorrhage for 3 months or at death,the changes of CEEG and prognosis in both groups were compared before and after treatment;and according to the clinicaleffect of CEEG in all the patients,divided the minto the CEEG-effective group(significantly improved+improved), the CEEG-ineffective group(unimproved+deteriorated), and analyzed the relationship between changes of CEEG and the prognosis.Results: Compared the clinical effect: On the whole, the improvement of CEEG in the mild-impairment patients and the moderate-impairment patients in the treatment group was better than that in the control group,difference being insignificant(P > 0.05);the improvement of CEEG of the severe-impairment patients in the treatment group was significantly better than those in the control group(P < 0.05);in the comparison of the obvious improvement rate and the total improvement rate among patients of all types,except that the total improvement of CEEG of moderateim pairment patients in the treatment group was better than that in the control group(P < 0.05),there were no significant differences being found in the comparison of the obvious improvement rate and the total improvement rate among patients of the other types in-between the two groups(P> 0.05).Compared the prognosis:On the whole,prognosis in the treatment was significantly better than that in the controlgroup(P < 0.05);comparing the favorable prognosis rate and the death rate of all types of patients,except that the favorable prognosis rate of severe-impairment patients in the treatment group was better than that in the control group(P < 0.05),there were no significant differences being found in the comparison of the favorable prognosis rate and the death rate among patients of the other types in-between the two groups(P>0.05).Analyzed the relationship between the clinical effect of CEEG and prognosis:On the whole,prognosis in the CEEG-effective group was better than that in the CEEG-ineffective group( P <0.05);among the mild-impairment patients,the death rate in the CEEG-effective group was lower than that in the CEEG-ineffective group(P < 0.05),while there were no significant differences being found in the comparison of the favorable rate in-between the two groups(P > 0.05);among the moderate-impairment patients,the favorable rate was higher and death rate was lower in the CEEG-effective group than those in the CEEG-ineffective group(P < 0.05);among the servere-impairment patients,the favorable rate in the CEEG-effective group was higher than that in the CEEG-ineffective group(P < 0.05),while there was no significant difference being found in the comparison of the death rate in-between the two groups(P>0.05).Conclusion:CEEG has considerable app lication value in the prognosis of patients with supratentorial intracerebral hemorrhage,and the intervention of Xingnaojing injection has significant clinical effect in CEEG and the prognosis of patients with supratentorial intracerebral hemorrhage,especially for the moderate-impairment patients.

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徐杰.醒脑静干预对幕上脑出血患者预后及连续脑电图的影响[J].新中医,2018,50(7):63-67

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  • 在线发布日期: 2018-07-09
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