血府逐瘀胶囊联合钻孔引流术治疗慢性硬膜下血肿的临床研究

Clinical study of Xuefu Zhuyu Capsule combined with drilling and drainage in the treatment of chronic subdural hematoma

目的探讨血府逐瘀胶囊(XZC)对接受钻孔引流手术(BHC)的慢性硬膜下血肿(CSDH)术后的临床疗效。方法回顾性收集大连市中心医院2016年1月至2019年12月收治的CSDH患者192例。采集纳入患者的临床一般情况、影像学资料以及预后相关资料,并收集为期6个月的随访记录。根据BHC术后使用XZC为治疗组(96例)和未使用XZC为观察组(96例),比较两组临床疗效和患者预后。采用Logistic回归模型进行单因素分析和多因素分析,以确定各种可能的影响因素之间的独立相关性。用比值比(OR)和95%CI评估相关因素与慢性硬膜下血肿术后疗效之间的关系。结果治疗组中87例(90.6%)患者术后达到治愈的效果,而观察组中只有76例患者(79.2%)治疗有效,两组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示BHC术后配合使用XZC治疗和术前格拉斯哥昏迷量表(GCS)评分是CSDH改善疗效的独立保护因素。结论CSDH患者术后使用XZC可以改善患者的临床疗效,术前GCS评分越高,患者预后越好。

Objective To identify the effects of Xuefu Zhuyu Capsule(XZC)on the surgical treatment of patients with chronic subdural hematoma(CSDH).Methods Retrospectively collected 96 pairs of patients who undergoing burr-hole craniotomy(BHC)for CSDH from January 2016 to December 2019 in Dalian Municipal Central Hospital.Clinical characteristics and imaging information of each patient were extracted,the follow-up period was six months.Differences in demographics and postoperative outcomes were compared between BHC+XZC group and BHC only group.Univariate analysis and multivariate analysis with Logistic regression model were performed to determine independent associations among the various probable effective factor.The relationship between related factors and effectiveness of CSDH was estimated with odds ratio(OR)and 95%CI.Results Effectiveness in 87 cases(90.6%)patients with surgery and received XZC postoperatively was significantly higher than 76 cases(79.2%)patients who underwent surgery alone.Multivariate Logistic regression analysis showed postoperative administration of XZC and preoperative Glasgow coma scale(GCS)score were independent protective factors for CSDH to improve therapeutic effect.Conclusions This study suggested postoperative administration of XZC for CSDH patients can improve the therapeutic effect,a higher preoperative GCS score is contributed to the postoperative effect.