Zhang Yueling, Song Ling, Zhao Jianfen
Yueling Zhang, Department of Operating Theatre Binzhou People's Hospital, Shandong, 256610, China.
Ling Song, Department of Cardiothoracic Surgery, Binzhou People's Hospital, Shandong, 256610, China.
Pak J Med Sci. 2019 Sep-Oct;35(5):1451-1455. doi: 10.12669/pjms.35.5.593.
Hypertensive intracerebral hemorrhage (HICH) is one of the common multiple diseases in neurology. Patients with severe HICH have high risk of disability and poor prognosis.
In order to explore the clinical effect of mild hypothermia combined with micro-traumatic evacuation of cerebral hemorrhage in the treatment of severe HICH, 136 patients with severe HICH were selected and divided into control group and study group using random number table method, 68 each group. The control group was treated with micro-traumatic evacuation of cerebral hemorrhage on the basis of conventional symptomatic treatment, while the study group was treated with mild hypothermia combined with micro-traumatic evacuation of cerebral hemorrhage on the basis of conventional symptomatic treatment. After treatment, the two groups were followed up for eight weeks.
The overall effective rate, residual hematoma volume, rebleeding rate, National Institute of Health stroke scale (NIHSS) score, Barthel index score and incidence of adverse reactions after treatment were observed and compared. The overall effective rate of the study group was 89.7%, which was significantly higher than that of the control group (67.6%). The mortality rate of the study group was 3.0%, which was significantly lower than that of the control group (14.7%, P<0.05). The residual hematoma volume and rebleeding rate of the study group were significantly lower than those of the control group (P<0.05). Before treatment, the NIHSS score and Barthel index score of the two groups had no significant differences (P>0.05). After treatment, they were improved, and the improvement of the study group was more significant (P<0.05). The incidence of adverse reactions in the study group was 10.0%, which was significantly lower than that in the control group (36.0%, P<0.05).
Mild hypothermia in combination with micro-traumatic evacuation of cerebral hemorrhage has significant clinical effect in the treatment of severe HICH. It can significantly improve neurological function and quality of life, causing few adverse reactions. Its clinical application value is high.
高血压性脑出血(HICH)是神经内科常见的多发病之一。重度HICH患者残疾风险高且预后差。
为探讨亚低温联合微创脑出血清除术治疗重度HICH的临床效果,选取136例重度HICH患者,采用随机数字表法分为对照组和研究组,每组68例。对照组在常规对症治疗基础上行微创脑出血清除术,研究组在常规对症治疗基础上行亚低温联合微创脑出血清除术。治疗后对两组进行为期8周的随访。
观察并比较两组治疗后的总有效率、残余血肿量、再出血率、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数评分及不良反应发生率。研究组总有效率为89.7%,显著高于对照组(67.6%)。研究组死亡率为3.0%,显著低于对照组(14.7%,P<0.05)。研究组残余血肿量和再出血率均显著低于对照组(P<0.05)。治疗前,两组NIHSS评分和Barthel指数评分比较,差异无统计学意义(P>0.05)。治疗后均有所改善,且研究组改善更显著(P<0.05)。研究组不良反应发生率为10.0%,显著低于对照组(36.0%,P<0.05)。
亚低温联合微创脑出血清除术治疗重度HICH临床效果显著,能显著改善神经功能和生活质量,不良反应少,临床应用价值高。