中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
4期
344-346
,共3页
苗雨露%赵万%余少雄%黄志斌%付红金%黄斌
苗雨露%趙萬%餘少雄%黃誌斌%付紅金%黃斌
묘우로%조만%여소웅%황지빈%부홍금%황빈
高血压脑出血%腰椎穿刺脑脊液置管换术
高血壓腦齣血%腰椎穿刺腦脊液置管換術
고혈압뇌출혈%요추천자뇌척액치관환술
Hypertensive intracerebral hemorrhage%Lumbar puncture and cerebrospinal fluid replacement
目的 探讨腰椎穿刺(腰穿)脑脊液置换术治疗高血压脑出血术后患者的临床治疗效果.方法 将高血压脑出血Ⅲ、Ⅳ级患者46例,按入院日期单双号分为实验组与对照组各23例,在开颅血肿清除,或开颅血肿清除+去骨瓣减压术,或开颅血肿清除+去骨瓣减压术+脑室外引流术等常规抢救治疗基础上,术后实验组加腰穿脑脊液置换术治疗,对照组不进行腰穿脑脊液置换术,其他治疗措施完全相同,比较2组疗效.结果 实验组术后1 d、5 d、7 d的栓溶二聚体水平分别为(0.89±0.11)mg/L、(0.58±0.12)mg/L、(0.42±0.11)mg/L;对照组分别为(0.87±0.15)mg/L、(1.13±0.18)mg/L、(0.95±0.12)mg/L.术后1 d2组DIM水平差异无统计学意义(P>0.05);术后5 d、7 d实验组DIM水平明显低于对照组,差异有统计学意义(P<0.05).实验组发生脑梗死3例、脑积水3例;GOS评分为良好6例,中残4例,重残6例,植物状态4例,死亡3例.对照组发生脑梗死7例、脑积水8例;GOS评分为良好2例、中残3例、重残3例、植物状态7例、死亡8例.2组疗效相比,实验组疗效优于对照组,差异有统计学意义(P<0.05).结论 腰穿脑脊液置换术治疗高血压脑出血Ⅲ、Ⅳ级术后患者,方法简单,效果肯定,能提高治愈率,减少病死率,值得推广.
目的 探討腰椎穿刺(腰穿)腦脊液置換術治療高血壓腦齣血術後患者的臨床治療效果.方法 將高血壓腦齣血Ⅲ、Ⅳ級患者46例,按入院日期單雙號分為實驗組與對照組各23例,在開顱血腫清除,或開顱血腫清除+去骨瓣減壓術,或開顱血腫清除+去骨瓣減壓術+腦室外引流術等常規搶救治療基礎上,術後實驗組加腰穿腦脊液置換術治療,對照組不進行腰穿腦脊液置換術,其他治療措施完全相同,比較2組療效.結果 實驗組術後1 d、5 d、7 d的栓溶二聚體水平分彆為(0.89±0.11)mg/L、(0.58±0.12)mg/L、(0.42±0.11)mg/L;對照組分彆為(0.87±0.15)mg/L、(1.13±0.18)mg/L、(0.95±0.12)mg/L.術後1 d2組DIM水平差異無統計學意義(P>0.05);術後5 d、7 d實驗組DIM水平明顯低于對照組,差異有統計學意義(P<0.05).實驗組髮生腦梗死3例、腦積水3例;GOS評分為良好6例,中殘4例,重殘6例,植物狀態4例,死亡3例.對照組髮生腦梗死7例、腦積水8例;GOS評分為良好2例、中殘3例、重殘3例、植物狀態7例、死亡8例.2組療效相比,實驗組療效優于對照組,差異有統計學意義(P<0.05).結論 腰穿腦脊液置換術治療高血壓腦齣血Ⅲ、Ⅳ級術後患者,方法簡單,效果肯定,能提高治愈率,減少病死率,值得推廣.
목적 탐토요추천자(요천)뇌척액치환술치료고혈압뇌출혈술후환자적림상치료효과.방법 장고혈압뇌출혈Ⅲ、Ⅳ급환자46례,안입원일기단쌍호분위실험조여대조조각23례,재개로혈종청제,혹개로혈종청제+거골판감압술,혹개로혈종청제+거골판감압술+뇌실외인류술등상규창구치료기출상,술후실험조가요천뇌척액치환술치료,대조조불진행요천뇌척액치환술,기타치료조시완전상동,비교2조료효.결과 실험조술후1 d、5 d、7 d적전용이취체수평분별위(0.89±0.11)mg/L、(0.58±0.12)mg/L、(0.42±0.11)mg/L;대조조분별위(0.87±0.15)mg/L、(1.13±0.18)mg/L、(0.95±0.12)mg/L.술후1 d2조DIM수평차이무통계학의의(P>0.05);술후5 d、7 d실험조DIM수평명현저우대조조,차이유통계학의의(P<0.05).실험조발생뇌경사3례、뇌적수3례;GOS평분위량호6례,중잔4례,중잔6례,식물상태4례,사망3례.대조조발생뇌경사7례、뇌적수8례;GOS평분위량호2례、중잔3례、중잔3례、식물상태7례、사망8례.2조료효상비,실험조료효우우대조조,차이유통계학의의(P<0.05).결론 요천뇌척액치환술치료고혈압뇌출혈Ⅲ、Ⅳ급술후환자,방법간단,효과긍정,능제고치유솔,감소병사솔,치득추엄.
Objective To study the clinical effect of the lumbar puncture cerebrospinal fluid replacement for post-operative hypertensive intracerebral hemorrhage Ⅲ,Ⅳ (HICH). Methods Fouty-six cases of post-opera-tion of hypertensive intracerebral hemorrhage Ⅲ, Ⅳ (HICH) were divided into experimental group and control group. Based on the routine rescue treatment, experimental group was treated with lumbar puncture cerebrospinal fluid replacement. The outcomes of two groups were compared. Results Each groups had 23 cases. The mortality was 13.0% in experimental group and 34.8% in control group, respectively(P<0.05). Dissolved dimer (DIM) in experimental group was significantly lower than that in control group (P<0.05). Prognosis of the experimental group was better than that in control group (P<0.05). The rates of severely disabled, cerebral infarction, hydro-cephalus in experimental group were lower than those in control group (P<0.05). The rates of middle disabled, vegetable states in experimental group showed no significant differences from control group(P>0.05). Conclusions Lumbar puncture cerebrospinal fluid replacement for post-operative hypertensive intracerebral hemorrhage Ⅲ, Ⅳ (HICH is simple and improves the cure rate and reduce mortality.
