补阳还五汤联合微创穿刺术治疗慢性硬膜下血肿患者临床疗效观察

Clinical Observation of Buyanghuanwu Decoction Combined with Minimally Invasive Puncture in Treatment of Chronic Subdural Hematoma

目的观察补阳还五汤联合微创穿刺术治疗慢性硬膜下血肿患者的临床疗效。方法 52例慢性硬膜下血肿患者随机分为两组。对照组22例采取微创穿刺术治疗,治疗组30例在对照组基础上给予补阳还五汤治疗,比较两组患者临床疗效、治疗前后神经功能缺损程度评分(CSS)、日常生活活动能力评分(ADL)以及术后残余血肿量百分比。结果治疗总有效率优于对照组患(P<0.05);术后10d、30d、90d两组患者CSS评分均较术前显著降低(P<0.05),且治疗组术后10d、30d、90d CSS评分显著低于对照组(P<0.05);术后10d、30d、90d两组患者ADL评分均较治疗前显著升高(P<0.05),且治疗组术后30d、90d ADL评分显著高于对照组(P<0.05);治疗组患者术后10d、30d、90d残余血肿量百分比均显著低于对照组(P<0.05)。结论补阳还五汤联合微创穿刺术治疗慢性硬膜下血肿,能够有效促进血肿的吸收,预防术后复发,且能够减轻患者的神经功能障碍。

Objective To observe the clinical effect of Buyanghuanwu decoction combined with minimally invasive puncture in treatment of chronic subdural hematoma. Methods 52 cases of chronic subdural hematoma were randomly divided into two groups. 22 patients of control group received minimally invasive surgical treatment,30 patients of treatment group received Buyanghuanwu decoction on the basis of control group. Clinical efficacy,Chinese Stroke Scale（ CSS） 、Activity of daily life（ ADL） and the percentage of the amount of residual postoperative hematoma were compared before and after treatment. Results The total effective rate in treatment group was better than that of control group（ P〈0. 05）; after surgery of 10 d,30d and 90 d,the CSS scores of two groups were significantly lower than before（ P〈0. 05）,and the treatment group was significantly lower than that of the control group（ P〈0. 05）; the ADL scores of two groups were significantly higher than before（ P〈0. 05）,and the ADL score of treatment group was significantly higher than that of the control group（ P〈0. 05）. The residual hematoma volumes were significantly lower than those in control group（ P〈0. 05）. Conclusion Buyanghuanwu decoction combined with minimally invasive puncture in treatment of chronic subdural hematoma can effectively promote hematoma absorption,prevent postoperative recurrence,and alleviate neural dysfunction.