补阳还五汤联合微创手术治疗外侧型小脑出血

Oral administration of Buyang Huanwu decoction combined with microinvasive operation on lateral cerebellar hemorrhage

关键词:  补阳还五汤  活血化瘀  微创手术  外侧型小脑出血

Key words:  Buyang Huanwu decoction  invigorating blood circulation and eliminating stasis  microinvasive operation  lateral cerebellar hemorrhage

摘要:

[目的] 补阳还五汤联合钻孔引流治疗外侧型小脑出血的疗效观察。[方法] 66 例出血量≥10 mL 的外侧型小脑出血,入院后即行脑室外引流术并行颅内压持续监测,在起病后的7～24 h接受局部麻醉下钻孔血肿引流术,然后随机分为两组,一组为中药治疗组,在术后24 h开始加用补阳还五汤(加味)进行活血化瘀治疗;另一组为对照组,不予中药。随访6 个月,对治疗效果进行对比。[结果] 中药治疗组患者的颅内压(ICP)在1周时要明显低于对照组,尤其出血量超过15 mL 的患者表现得最明显。6 个月时中药组的总有效率为81.0%(17/21)优于对照组71.4%(15/21)。[结论] 补阳还五汤联合钻孔引流手术治疗外侧型小脑出血,安全可靠,疗效显著。

Abstract:

[Objective] To study the therapeutic effect of oral administration of Buyang Huanwu decoction combined with microinvasive operation on lateral cerebellar hemorrhage. [Methods] In this study, 66 patients with lateral cerebellar hemotoma (volume≥10 mL) were taken external ventricular drainage immediately after admission and then taken continuous monitoring of intracranial pressure (ICP). Trepanation and drainage of hematoma was done under local anesthesia with 7~24 hrs after the onset. All patients were divided into 2 groups randomly: the Chinese medicine treatment group(given Buyang Huanwu decoction 24 hrs after the operation) and the control group. During six-months follow-up, we compared the therapeutic effect between two groups. [Results] The ICP of the Chinese medicine treatment group was obviously lower than that of the control at one week after therapy, and the difference was much more obvious when the hemotoma volume was over 15 mL. At the end of the six-months follow-up, the Chinese medicine treatment group gained a better performance than the control, with a total efficiency of 81.0%(17/21) vs.71.4%(15/21). [Conclusion] Oral administration of Buyang Huanwu decoction combined with microinvasive operation is safe and effective on the treatment of lateral cerebellar hemorrhage.