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目的:观察中西医结合综合方案治疗脑出血后脑积水的临床效果。方法:选取2012年07月~2015年06月我院急诊科收治的126例脑出血后脑积水患者为研究对象,随机数字表法将患者分为观察组和对照组,每组63例,对照组采用西医内科基础治疗,观察组采用中西医结合综合方案,治疗2个疗程后,察比较两组疗效、治疗前和治疗后第7天及14天颅内压值,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯昏迷评分(GSC)评分和生活能力评价(BartheI)指数(BI指数),同时观察治疗期间两组患者不良反应。结果:观察组患者临床治疗总有效率(79.37%)显著高于对照组(55.56%),同时观察组患者死亡率(6.35%)显著低于对照组(20.63%),差异均具有统计学意义(χ~2=8.135和4.352,P<0.05)。治疗后第7天及14天两组患者颅内压较治疗前显著降低,观察组颅内压均明显低于对照组(P<0.05)。治疗后观察组患者NIHSS评分、GSC评分及BI指数改善程度显著优于对照组(P<0.05)。两组患者在不良反应发生上差异不具有统计学意义(P>0.05)。结论:中西医结合治疗方案治疗脑出血后脑积水疗效显著,能够迅速改善患者临床症状,降低颅内压,改善患者神经功能和提高患者生活质量,安全性高且疗效明显优于单独西医治疗。
Objective: To observe the clinical effect of integrated traditional Chinese and western medicine in the treatment of hydrocephalus after intracerebral hemorrhage. Methods: One hundred and sixty-six patients with hydrocephalus after cerebral hemorrhage admitted from our hospital emergency department from July 2012 to June 2015 were enrolled in this study. Patients were divided into observation group and control group by random number table method, with 63 cases in each group. The treatment group was treated with western medical basic treatment. The observation group was treated with integrated traditional Chinese and western medicine. After two courses of treatment, the curative effect of the two groups were compared. The intracranial pressure before and 7 days and 14 days after treatment were compared. National Institutes of Health Stroke Scale (NIHSS) score, Gras coma score (GSC) and Barthel Index (BI index) were measured. Adverse reactions of two groups were observed during the treatment. Results: The total effective rate (79.37%) in observation group was significantly higher than that in control group (55.56%), while the mortality rate in observation group (6.35%) was significantly lower than that in control group (20.63%) (χ ~ 2 = 8.135 and 4.352, P <0.05). The intracranial pressure of the two groups decreased significantly on the 7th day and the 14th day after treatment, and the intracranial pressure in the observation group was significantly lower than that of the control group (P <0.05). After treatment, NIHSS score, GSC score and BI index in observation group were significantly better than those in control group (P <0.05). There was no significant difference between the two groups in the incidence of adverse reactions (P> 0.05). Conclusion: The combination of traditional Chinese and western medicine treatment of hydrocephalus after intracerebral hemorrhage significant effect, can rapidly improve clinical symptoms, reduce intracranial pressure, improve neurological function and improve patient quality of life, high safety and efficacy is superior to Western medicine alone.