激素对慢性硬膜下血肿治疗机制的研究

Study of the therapeutic mechanism of chronic subdural hematoma by hormone

目的探讨激素对慢性硬膜下血肿的治疗机制。方法选取2015年8月~2016年12月我院收治的53例慢性硬膜下血肿患者作为研究对象,采用随机分组方法将其分为对照组与实验组,对照组26例患者实施钻孔引流术+术中冲洗及术后加大补液量治疗,实验组27例患者在钻孔引流术的基础上实施激素治疗。比较两组患者的治疗效果、复发率、血凝块溶解再出血发生率、术后生活质量评分及住院时间等。结果两组患者的治疗总有效率比较,差异无统计学意义(P>0.05);实验组患者治疗后的复发率(7.41%)、血凝块溶解再出血发生率(18.52%)低于对照组(23.36%、27.63%),差异均有统计学意义(P<0.05);实验组患者的术后生活质量评分高于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。结论针对慢性硬膜下血肿患者实施钻孔引流术治疗,其术后并发症少,但术后复发现象较多,不利于患者预后,采用激素治疗能显著降低复发率,促进患者预后。

Objective To investigate the therapeutic mechanism of hormone on chronic subdural hematoma.Methods From August 2015 to December 2016,53 patients with chronic subdural hematoma admitted to our hospital were selected as subjects and randomly divided into control group and experimental group.In the control group （n=26）,treatment including borehole drainage,intraoperative rinse and postoperative intensive fluid replacement was used,while in the experimental group （n=27）,hormone was applied on the basis of borehole drainage.The therapeutic effect,recurrence rate, incidence of re-bleeding after clot lysis,postoperative quality of life score and hospital stay in the two groups were compared.Results The total effective of the two groups was compared,and the difference was not statistically significant （P〉0.05）.Afier treatment,the recurrence rate （7.41%） and incidence of re-bleeding after clot lysis （18.52%） of patients in the experimental group were lower than those in the control group （23.36%,27.63%）,and the differences were statistically significant （P〈0.O5）.The postoperative quality of life score of patients in the experimental group was higher than that of the control group,the hospitalization time was shorter than that in the control group,and the differences were statistically significant （P〈0.05）.Conclusion According to the results,implementation of borehole drainage for the patients with chronic subdural hematoma have less postoperative complications,but with plenty of recurrent manifestations which are not helpful in patients＇ prognosis.Application of hormone therapy can significantly reduce the recurrence rate and promote the prognosis of patients.