立体定向微创术联合活血利水醒脑中药治疗脑桥出血疗效观察

The efficacy observation of stereotactic minimally invasive surgery combined with traditional Chinese medicine treatment on pontine Hemorrhage

目的探讨立体定向微创术联合活血利水醒脑中药治疗脑桥出血的临床疗效。方法回顾性分析36例脑桥出血患者的临床资料,按治疗方式的不同分为2组各18例。对照组西医常规保守治疗,观察组立体定向微创置管、引流术+活血利水醒脑中药+西医常规治疗。观察对比指标包括清醒时间及清醒率、格拉斯哥预后评分(GOS)及病死率、并发症发生率。结果观察组18例手术均获成功,无手术死亡病例,术后因肺部感染死亡2例,存活16例,病死率11.11%;对照组18例患者中存活1例,随访3个月后死亡,其他病例均于发病后14d内死亡,平均死亡时间12.25d,病死率100%。观察组的GOS评分、清醒时间及清醒率优于对照组,且并发症发生率低于对照组,差异均有统计学意义(P<0.01)。结论采用立体定向微创术联合活血利水醒脑中药治疗脑桥出血疗效显著,值得临床推广。

Objective To study the efficacy of stereotactic minimally invasive surgery combined with traditional Chinese medicine on pontine hemorrhage.Methods Clinical datas of 36 cases with pontine hemorrhage were retrospectively analysed and divided into two groups according to the different methods of treatment ,each group with 18 cases repectively.The control group recieved conventional western medicine treatment ;the observation group were given stereotactic minimally invasive sur-gery＋ traditional Chinese medicine ＋ routine western medicine treatment. Observation indexes include ：waking time and sober rate ;Glasgow outcome score （GOS） and mortality ;complication rates.Results 18 cases in treatment group were successful , no surgical deaths ,2 cases died of pulmonary infection ,postoperative survival was 16 cases ,the mortality rate was 11.11% ;1 case survived in the control group ,died after 3 months ,other cases died within 14 days after onset ,the average death time was 12.25 days ,the mortality rate was 100%. The GOS score and awake time and rate of observation group were better than those of control group ,and the complication rate was lower than that of the control group ,the difference had statistical signifi-cance （P〈0.05）. Conclusion The efficacy of stereotactic minimally invasive surgery combined with traditional Chinese medi-cine on pontine hemorrhage is significant ,and is worth of clinical promotion.