CAJ | 학술논문

目的探讨亚低温治疗在脑出血血肿抽吸术后治疗的临床疗效和安全性.方法 202例脑出血行血肿抽吸术治疗的患者, 随机分为观察组(102例)和对照组(100例), 术后分别予以常规内科治疗和亚低温治疗, 纪录两组治疗前后血清神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)水平, 比较美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数.结果两组治疗前及治疗后3、7 d NSE水平比较差异无统计学意义(P>0.05), 表现为逐渐升高趋势, 而治疗后14 d NSE下降, 观察组下降幅度较对照组大, 差异有统计学意义(P<0.05);两组治疗前hs-CRP水平比较差异无统计学意义(P>0.05), 治疗后表现为先升后降, 观察组峰值提前, 下降也提前于对照组, 差异有统计学意义(P<0.05);两组治疗前及治疗后3、7 d NIHSS评分比较差异无统计学意义(P>0.05), 而治疗后14 d观察组显著低于对照组, 差异有统计学意义(P<0.05);随访3个月后观察组患者Barthel指数平均(71.34±23.15)分, 显著高于对照组(57.54±22.67)分, 差异有统计学意义(P<0.05).结论亚低温治疗配合血肿抽吸术给患者带来更好的预后, 值得推广使用.
목적 탐토아저온치료재뇌출혈혈종추흡술후치료적림상료효화안전성.방법 202례뇌출혈행혈종추흡술치료적환자, 수궤분위관찰조(102례)화대조조(100례), 술후분별여이상규내과치료화아저온치료, 기록량조치료전후혈청신경원특이성희순화매(NSE)、초민C반응단백(hs-CRP)수평, 비교미국국립위생연구원졸중량표(NIHSS)평분화Barthel지수.결과 량조치료전급치료후3、7 d NSE수평비교차이무통계학의의(P>0.05), 표현위축점승고추세, 이치료후14 d NSE하강, 관찰조하강폭도교대조조대, 차이유통계학의의(P<0.05);량조치료전hs-CRP수평비교차이무통계학의의(P>0.05), 치료후표현위선승후강, 관찰조봉치제전, 하강야제전우대조조, 차이유통계학의의(P<0.05);량조치료전급치료후3、7 d NIHSS평분비교차이무통계학의의(P>0.05), 이치료후14 d관찰조현저저우대조조, 차이유통계학의의(P<0.05);수방3개월후관찰조환자Barthel지수평균(71.34±23.15)분, 현저고우대조조(57.54±22.67)분, 차이유통계학의의(P<0.05).결론 아저온치료배합혈종추흡술급환자대래경호적예후, 치득추엄사용.
Objective To investigate clinical effect and safety of mild hypothermia therapy after hematoma aspiration for intracerebral hemorrhage.Methods A total of 202 intracerebral hemorrhage patients receiving hematoma aspiration were randomly divided into observation group (102 cases) and control group (100 cases). The two groups respectively received conventional medical treatment and mild hypothermia therapy. Records were made on their serum neuron specific enolase (NSE) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treamtent. Their national institutes of health stroke scale (NIHSS) scores and Barthel indexes were compared.Results There was no statistically significant difference of NSE levels between the two groups before and in 3 and 7 d after treatment (P>0.05), with an increasing trend. While they had decreased NSE in 14 d after treatment, and the observation group had larger decrease than the control group. Their difference had statistical significance (P<0.05). Before treatment, the difference of hs-CRP levels had no statistical significance between the two groups (P>0.05). Their manifestations after treatment showed increasing trend followed by decreased trend. The observation group had earlier peak value and decrease time than the control group, and their difference had statistical significance (P<0.05). There was no statistically significant difference of NIHSS scores between the two groups before and in 3 and 7 d after treatment (P>0.05). In 14 d after treatment, the observation group had much lower NIHSS score than the control group, and the difference had statistical significance (P<0.05). After 3-month follow-up, the observation group had obviously higher average Barthel index as (71.34±23.15) points than (57.54±22.67) points of the control group. Their difference had statistical significance (P<0.05). Conclusion Mild hypothermia therapy in coordination with hematoma aspiration can bring good prognosis for patients, and this method is worth promoting and applying.