立体定向穿刺抽吸术联合醒脑静治疗高血压性脑出血疗效分析

目的：观察并探讨立体定向穿刺抽吸术联合早期应用醒脑静注射液治疗高血压性脑出血的临床疗效。方法：入选2010年2月—2012年12月80例高血压脑出血患者为研究对象,随机分为观察组（n=42例）与对照组（n=38例）,两组患者均行立体定向穿刺血肿抽吸术＋术后支持性治疗,观察组患者入院后即给予醒脑静注射液静脉滴注,疗程14d,记录并对比两组患者治疗后脑水肿消退情况、神经功能缺损情况及临床疗效。结果：①治疗2周后,两组患者脑水肿体积显著缩小,观察组患者脑水肿体积（5.2±0.8）mL明显小于对照组（5.7±0.9）mL（t=2.615P=0.011）。②两组患者神经功能缺损评分显著降低,观察组缺损评分（17.5±2.7）低于对照组（18.9±3.0）（t=2.185P=0.032）。③观察组基本治愈比例（47.6%）与总体有效率（90.5%）均高于对照组（39.5%、81.6%）,差异均不具有统计学意义（Z=-1.125,P=0.261;χ2=1.322,P=0.249）;两组病死率（7.1%vs13.2%）无显著性差异（fisherP=0.467）。结论：立体定向穿刺抽吸术联合早期应用醒脑静注射液治疗高血压性脑出血能较彻底清除血肿,减轻脑水肿,有利于神经功能恢复,并一定程度上降低病死率。

Clinical Efficacy of Stereotactic Aspiration Combined with Xingnaojing Injection in Treatment of Hypertensive Cerebral Hemorrhage Study

Objective ： To observe the clinical efficacy of stereotactic aspiration combined with Xingnaojing Injection in treatment of hypertensive cerebral hemorrhage. Methods ： 80 admitted cases from Feb.2010 to Dec.2012 were selected as study objects and were randomly arranged into observation group（n=42 cases） and control group （ n=38 cases ）, both 2 groups applied stereotactic aspiration and supporting treatment postoperatively, and observation group patients were given Xingnaojing Injection for 14 d after admission. The cerebral edema, nerve functional failure and clinical efficacy were noted and compared between 2 groups after treatment. Results ： ①2 weeks after treatment, two groups patients cerebral edema volume was significantly reduced, cerebral edema volume of patients in observation group （ 5.2 ± 0.8 ） mL was significantly less than that of control group （5.7 ± 0.9 ）mL （t=2.615, P=0.011 ）. ② Nerve functional failure scores of two groups were significantly reduced, the observation group score （ 17.5 ± 2.7 ）was significantly lower than that of control group （ 18.9 ± 310 ） （ t=2.185, P=0.032 ）. ③The observation group＇s cured proportion （ 47.6% ） and overall efficiency ratio （ 90.5% ）were both higher than those of control group （ 39.5%, 81.6% ）, and the differences were not statistically significant （ Z=-1. 125, P=0.261 ; χ2=1-322, P=0.249 ） ; mortality rate of two groups （ 7.1% vs.13.2% ） had no significant difference （ fisher P=0.467 ）. Conclusion ： Stereotactic aspiration combined with early application of Xingnaojing Injection for treatment of hypertensive cerebral hemorrhage can thoroughly remove the hematoma, alleviate cerebral edema, be beneficial to the recovery of neural function, and to a certain extent reduce the mortality rate.