论文部分内容阅读
目的:观察中西医结合防治蛛网膜下腔出血后迟发性脑血管痉挛的临床疗效。方法:将符合纳入标准的48例患者,随机分为对照组和试验组各24例,对照组予以常规治疗和尼莫地平注射液防治迟发性脑血管痉挛,试验组在对照组的基础上加用天麻熄风汤,观察21天。观察2组治疗前后颅内血流速度的改变,迟发性脑血管痉挛、脑梗死的发生率。结果:第1、7、14、21天试验组在经颅超声多普勒(TCD)检测下双侧大脑中动脉及基底动脉的血流速度均小于对照组,差异均有显著性意义(P<0.05),提示试验组相对于对照组显著降低了血流速度。观察期内试验组脑血管痉挛发生6例,总发生率25.0%,对照组发生14例,总发生率58.3%,2组比较,差异有显著性意义(P<0.05)。试验组患者脑梗死发生率(颅脑CT判定)为4.2%,对照组为29.2%,2组比较,差异有显著性意义(P<0.05)。试验组1例迟发性脑血管痉挛治疗无效,总有效率为83.3%,对照组7例迟发性脑血管痉挛无效,总有效率为50.0%,2组比较,差异有显著性意义(P<0.05)。结论:中西医结合治疗能降低迟发性脑血管痉挛的发生,降低蛛网膜下腔出血后脑梗死的发生,改善预后。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in prevention and treatment of delayed cerebral vasospasm after subarachnoid hemorrhage. Methods: Forty-eight patients who met the inclusion criteria were randomly divided into control group and experimental group with 24 cases each. The control group was given routine treatment and nimodipine injection was used to prevent and treat delayed cerebral vasospasm. On the basis of the control group Add Tianma Xifeng soup, observed 21 days. The changes of intracranial blood flow velocity, delayed cerebral vasospasm and cerebral infarction in two groups before and after treatment were observed. Results: On the 1st, 7th, 14th and 21st days, the blood flow velocity of bilateral middle cerebral artery and basilar artery in the experimental group was lower than that of the control group by transcranial Doppler ultrasound (TCD), the difference was significant (P <0.05), suggesting that the experimental group significantly reduced blood flow velocity compared with the control group. During the observation period, 6 cases of cerebral vasospasm occurred in the experimental group, with a total incidence of 25.0%. There were 14 cases in the control group with a total incidence of 58.3%. There was significant difference between the two groups (P <0.05). The incidence of cerebral infarction in patients in test group (brain CT determination) was 4.2%, while that in control group was 29.2%. There was significant difference between the two groups (P <0.05). One case of delayed cerebral vasospasm was ineffective in the experimental group, with a total effective rate of 83.3%. Seven cases of delayed cerebral vasospasm in the control group were ineffective with a total effective rate of 50.0%. There was significant difference between the two groups (P <0.05). Conclusion: Integrative Medicine can reduce the occurrence of delayed cerebral vasospasm, reduce the occurrence of cerebral infarction after subarachnoid hemorrhage and improve the prognosis.