脑出血患者保守治疗的临床疗效分析

Clinical Analysis of Conservative Treatment for Patients with Cerebral Hemorrhage

目的分析脑出血患者保守治疗的临床疗效。方法研究阶段为2016年1月—2017年12月,共纳入研究对象87例,均为年龄大于65岁,出血量大于30 mL幕上脑出血患者,根据入院顺序先后分为对照组42例和观察组45例,对照组采用手术治疗,观察组常规保守治疗,比较两组临床效果。结果观察组治疗总有效率82.22%(37/45)与对照组80.85%(34/42),差异无统计学意义(P>0.05)。对照组治疗前CSS评分(23.01±5.88)分、治疗后15 d CSS评分(19.19±5.93)分、治疗后1个月CSS评分(10.57±3.45)分与观察组治疗前CSS评分(22.92±5.92)分、治疗后15 d CSS评分(18.99±5.59)分、治疗后1个月CSS评分(9.93±3.01)分差异无统计学意义(t=0.012、0.935、0.044,P>0.05)。对照组治疗前GOS评分(2.37±0.39)分、治疗后GOS评分(4.18±0.09)分与观察组治疗前GOS评分(2.39±0.38)分、治疗后GOS评分(4.31±0.12)分差异无统计学意义(t=0.075、0.042,P>0.05)。结论针对高血压脑出血患者不可过分强调保守治疗或手术治疗,针对无法耐受手术或出血量比较小的患者可考虑采用内科保守治疗。

Objective To analyze the clinical efficacy of conservative treatment for patients with cerebral hemorrhage.Methods The study period was from January 2016 to December 2017. A total of 87 subjects were enrolled, all of whomwere older than 65 years old. The bleeding volume was greater than 30 mL. Patients with supratentorial cerebral hem-orrhage were divided into control group 42 cases and observation group 45 case according to the order of admission.The control group was treated with surgery, and the observation group was routinely treated conservatively. The clinicaleffects of the two groups were compared. Results The total effective rate of observation group was 82.22%（37/45） and80.85% （34/42） of the control group. The difference was not significant（P〈0.05）. The control group had a pre-treatmentCSS score （23.01±5.88）points, a 15-day CSS score （19.19±5.93）points, a 1-month CSS score （10.57±3.45）points, and apre-treatment CSS score of the observation group （22.92±5.92）points. The CSS score （18.99±5.59）points after 15 days oftreatment and the CSS score（9.93±3.01）points at 1 month after treatment were not significantly different （t=0.012, 0.935,0.044, P〈0.05）. In the control group, the GOS score （2.37±0.39）points and the GOS score （4.18±0.09）points after treat-ment were not significantly different from the GOS score （2.39±0.38）points and the GOS score （4.31±0.12）points aftertreatment. Not statistically significant （t= 0.075, 0.042, P〉0.05）. Conclusion For patients with hypertensive cerebralhemorrhage, conservative treatment or surgical treatment should not be over-emphasized. For patients who cannot toler-ate surgery or have a small amount of bleeding, conservative medical treatment may be considered.