腰大池置管引流结合镇肝泻热活血中药治疗动脉瘤性蛛网膜下腔出血的研究

Study on the effect of continuous lumbar cistern tube drainage combined with suppressing liver Yang and purging heat and activating blood Chinese herbs on aneurysmal subarachnoid hemorrhage

目的探讨腰大池置管持续引流结合镇肝泻热活血中药内服治疗动脉瘤性蛛网膜下腔出血的临床疗效。方法选取78例经脑CT检查确定为Fisher分级Ⅱ级以上的动脉瘤破裂蛛网膜下腔出血患者,随机分为对照组38例和治疗组40例,2组均常规给予脱水降颅压、能量支持、调控血压、胃黏膜保护、神经营养、缓解血管痉挛、营养支持等治疗,均在血管内介入栓塞术后第2天予床边行腰椎穿刺腰大池置管持续引流处理。治疗组在上述基础上给予镇肝泻热活血中药内服,对照组给予等量生理盐水内服。结果治疗组脑血管痉挛改善情况、临床恢复良好率显著优于对照组,致残率和致死率明显低于对照组。结论腰大池置管持续引流结合镇肝泻热活血中药内服治疗动脉瘤破裂蛛网膜下腔出血疗效好,能降低脑血管痉挛发生率,较好改善患者的临床预后,降低致残率和致死率,是一种值得推广的中西医结合治疗方法。

Objective It is to investigate the clinical effect of continuous lumbar cistern tube drainage combined with sup-pressing liver Yang and purging heat and activating blood Chinese herbs on aneurysmal subarachnoid hemorrhage. Methods 78patients with head CT examination to determine the aneurysm above Fisher grade II in patients with subarachnoid hemorrhagewere selected. They were randomly divided into control group of 38 cases and 40 cases in the treatment group. All the patientsin both groups were treated with internal medicine routine dehydration, reducing intracranial pressure, energy support protec-tion of gastric mucosa, nerve nutrition, alleviate vasospasm, nutritional support therapy. On the second day after interventionalembolization they were underwent lumbar puncture continuous lumbar cistern tube drainage treatment in bed. The treatmentgroup was given suppressing liver Yang and purging heat and activating blood Herbs treatment based on the treatment in theDepartment of internal medicine, the control group normal was given the same dosis saline orally. Results In treatment group,the recovery rate was significantly better, the morbidity and mortality were significantly lower than that of the control group, thedifferences between the two groups were statistically significant. Conclusion Continuous lumbar cistern tube drainage combinedwith suppressing liver Yang and purging heat and activating blood herbs can improve the prognosis of patients significantly, re-duce morbidity and mortality in the treatment of aneurysmal subarachnoid hemorrhage. This treatment is a worthy method oftraditional Chinese medicine and western medicine.