發(fā)布時(shí)間：2018-06-21 05:15

  本文選題：出血性卒中 + 顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥��； 參考：《湖北中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的：比較出血性卒中（即腦出血ICH）出血量25~60ml的內(nèi)科保守治療和6-72h早期顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥治療兩種治療方案，觀察腦出血早期顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥的臨床療效。 方法：以2013年8月至2014年3月期間襄陽市襄州區(qū)人民醫(yī)院神經(jīng)內(nèi)科一病區(qū)收治的原發(fā)性腦出血（ICH）出血量25~60ml患者50例為研究對象，根據(jù)嚴(yán)格的納入標(biāo)準(zhǔn)，遵循知情同意原則，向患者直系家屬充分告知內(nèi)科保守、6-72h早期顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥兩者各自的利弊，將患者分為顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥組（微創(chuàng)聯(lián)合組）和內(nèi)科保守治療組（保守組）。比較兩組患者的近期療效和遠(yuǎn)期療效。近期療效指標(biāo)為GCS評分，血腫體積，住院期間死亡率，住院天數(shù)；遠(yuǎn)期療效指標(biāo)為術(shù)后3個(gè)月隨訪的日常生活活動能力（ADL）評分。住院期間相關(guān)指標(biāo)，組間比較采用χ2檢驗(yàn)，計(jì)量資料采用t檢驗(yàn)進(jìn)行分析。 結(jié)果：在近期療效中GCS評分，血腫量，住院時(shí)間方面，微創(chuàng)聯(lián)合組具有更大的優(yōu)勢，住院期間死亡率兩組無統(tǒng)計(jì)學(xué)意義；遠(yuǎn)期療效為術(shù)后3個(gè)月隨訪的日常生活活動能力（ADL）評分，內(nèi)科保守治療組與6-72h早期顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥組相比無顯著性差異（P0.05）。 結(jié)論：出血性卒中出血量25~60ml的內(nèi)科保守治療和6-72h早期顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥在遠(yuǎn)期療效方面無明顯差異，但結(jié)合近期療效如GCS評分，血腫體積，住院天數(shù)等指標(biāo)，我們認(rèn)為6-72h早期顱內(nèi)血腫微創(chuàng)清除術(shù)聯(lián)合中醫(yī)中藥是治療出血性卒中的一個(gè)較好方法。
[Abstract]:Objective: to compare the internal conservative treatment of hemorrhagic apoplexy (ICH) and the minimally invasive excision of intracranial hematoma (ICH) combined with traditional Chinese medicine (TCM) for 6 to 72 hours after intracerebral hemorrhage. To observe the clinical effect of minimally invasive removal of intracranial hematoma in early stage of intracerebral hemorrhage combined with traditional Chinese medicine. Methods: from August 2013 to March 2014, 50 25~60ml patients with primary intracerebral hemorrhage (ICH) in Department of Neurology, Xiangzhou people's Hospital, Xiangyang City, were selected as subjects. According to the strict inclusion criteria, the principle of informed consent was followed. To fully inform the immediate family members of the patients of the advantages and disadvantages of minimally invasive removal of intracranial hematoma in the early period of 6-72 hours of internal medicine combined with traditional Chinese medicine. The patients were divided into two groups: minimally invasive removal of intracranial hematoma combined with traditional Chinese medicine (minimally invasive combined group) and conservative treatment group (conservative group). The short-term and long-term outcomes were compared between the two groups. The short-term curative effect indexes were GCS, hematoma volume, mortality during hospitalization, hospitalization days, and ADL score of daily living activity (ADL) after 3 months follow-up. The relative indexes during hospitalization were analyzed by 蠂 2 test and t test respectively. Results: GCS score, hematoma volume and length of stay in the short-term curative effect, the minimally invasive combined group had more advantages, but there was no significant difference between the two groups in the mortality rate during hospitalization. The long-term curative effect was ADL score after 3 months follow-up. There was no significant difference between the conservative treatment group and the early intracranial hematoma removal group combined with traditional Chinese medicine at 6-72 hours (P 0.05). Conclusion: there is no significant difference in long-term curative effect between conservative treatment of hemorrhagic stroke volume of 25~60ml and minimally invasive removal of intracranial hematoma from 6 to 72 hours in combination with traditional Chinese medicine, but combined with short-term curative effect such as GCS score, hematoma volume, length of stay in hospital and so on. We think that minimally invasive excision of intracranial hematoma in 6-72 hours combined with Chinese medicine is a better method for the treatment of hemorrhagic apoplexy.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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