發(fā)布時間：2019-04-09 16:49

【摘要】：目的探討口服氨甲環(huán)酸對混雜密度慢性硬膜下血腫保守治療的療效。方法選取2013年1月至2016年6月就診于我院的混雜密度慢性硬膜下血腫22例,全組病例均行頭顱CT平掃確診。所有患者均口服氨甲環(huán)酸250mg每日3次,治療1~3月,隨訪4~6個月。比較患者用藥前后血腫量的變化,神經(jīng)功能恢復(fù)情況,觀察頭顱CT的演變過程。結(jié)果有效16例(72.7%),無效4例(18.2%),失訪2例(9.1%)。16例(72.7%)在治療1個月后,頭疼、肢體乏力等臨床癥狀均有改善,3個月后臨床癥狀基本消失,頭顱CT示血腫明顯吸收。3例因口服藥物3~4周后臨床癥狀加重收住院行手術(shù)治療,術(shù)后繼續(xù)口服氨甲環(huán)酸,隨訪6個月無1例復(fù)發(fā)。1例在服藥1個月后臨床癥狀明顯好轉(zhuǎn),血腫大部分呈低密度影,血腫吸收減少,后因消化道不適停止服藥。2例分別在服藥8周及12周后失訪。結(jié)論口服氨甲環(huán)酸保守治療混雜密度慢性硬膜下血腫安全有效,同時可減少混雜密度CSDH鉆孔引流術(shù)后復(fù)發(fā)。
[Abstract]:Objective to evaluate the efficacy of oral carbacycloic acid in the conservative treatment of mixed density chronic subdural hematoma. Methods from January 2013 to June 2016, 22 patients with mixed density chronic subdural hematoma were selected. All patients were diagnosed by head CT plain scan. All patients were treated with 250mg 3 times a day for 1 to 3 months and followed up for 4 months for 6 months. The changes of hematoma volume and the recovery of neurological function were compared before and after treatment, and the evolution of brain CT was observed. Results 16 cases (72.7%) were effective, 4 cases (18.2%) were ineffective, 2 cases (9.1%) were lost follow-up, 16 cases (72.7%) had improved clinical symptoms such as headache and limb fatigue after 1 month treatment. The clinical symptoms disappeared after 3 months and the hematoma was obviously absorbed by CT in the head. 3 cases were admitted to hospital for 3 weeks because of the aggravation of clinical symptoms after 3 weeks of oral medication, and then they continued to take carbaric acid orally after operation. After 6 months of follow-up, no recurrence was found in 1 case, the clinical symptoms were obviously improved after 1 month's treatment, most of the hematoma showed low density shadow, hematoma absorption decreased, and then stopped taking medicine because of digestive tract discomfort. 2 cases lost follow-up after 8 weeks and 12 weeks, respectively. Conclusion it is safe and effective to treat chronic subdural hematoma with mixed density by oral administration of carbacycloic acid. It can also reduce the recurrence of CSDH drainage with mixed density.
【作者單位】： 綿竹市人民醫(yī)院成都醫(yī)學(xué)院附屬綿竹醫(yī)院;
【分類號】：R741

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