目的 探討鼠神經(jīng)生長(zhǎng)因子聯(lián)合奧拉西坦治療重型急性顱腦損傷的臨床療效.方法 選擇2011 年1 月-2014 年12月濮陽(yáng)市油田總醫(yī)院收治的重型急性顱腦損傷患者90 例,隨機(jī)分為對(duì)照組和治療組,每組各45 例.對(duì)照組靜脈滴注注射用奧拉西坦,將4.0 g 注射用奧拉西坦加入250 mL 生理鹽水中,1 次/d.治療組在對(duì)照組基礎(chǔ)上im 注射用鼠神經(jīng)生長(zhǎng)因子,用2 mL 生理鹽水溶解30 μg,1 次/d.兩組均連續(xù)治療14 d.觀察兩組的臨床療效,同時(shí)比較兩組美國(guó)國(guó)立衛(wèi)生院神經(jīng)功能缺損(NIHSS)評(píng)分、格拉斯哥昏迷(GCS)評(píng)分及Glasgow(GOS)評(píng)分分級(jí)情況.結(jié)果 治療后,對(duì)照組和治療組總有效率分別為66.67%、88.89%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05).治療第3、7、14 天兩組NIHSS 評(píng)分均較治療前顯著降低,GCS 評(píng)分顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);治療第7、14 天治療組NIHSS 和GCS 評(píng)分的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).對(duì)照組和治療組的良好率分別為31.11%、46.67%,清醒率分別為53.33%、71.11%,兩組良好率和清醒率比較差異均有統(tǒng)計(jì)學(xué)意義(P< 0.05).結(jié)論 鼠神經(jīng)生長(zhǎng)因子聯(lián)合奧拉西坦治療重型急性顱腦損傷具有較好的臨床療效,能夠促進(jìn)患者清醒,改善預(yù)后,具有一定的臨床推廣應(yīng)用價(jià)值.

Objective To investigate the clinical efficacy of mouse nerve growth factor combined with oxiracetam in treatment of acute severe craniocerebral injury. Methods Patients (90 cases) with acute severe craniocerebral injury in Puyang Oilfield General Hospital from January 2011 to December 2014 were randomly divided into control and treatment groups. Each group had 45 cases. Patients in control group were iv administered with Oxiracetam for injection (4.0 g Oxiracetam for injection added 250 mL physiological saline), once daily. Patients in treatment group were im administered with Mouse Nerve Growth Factor for injection (30 μg Mouse Nerve Growth Factor for injection dissolved in physiological saline 2 mL), once daily. Patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, and NIHSS score, GCS score, and GOS classification in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 66.67% and 88.89%, respectively, and there were differences between two groups (P < 0.05). NIHSS scores in two groups were significantly reduced on days 3, 7, and 14 of the treatment, and GCS scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). NIHSS and GCS scores in the treatment group improved better than those in the control group on days 7 and 14 of the treatment, with significant differences between two groups (P < 0.05). The good rates in the control and treatment groups were 31.11% and 46.67%, respectively, while awake rate in two groups were 53.33% and 71.11%, and there were differences between two groups (P < 0.05). Conclusion Mouse nerve growth factor combined with oxiracetam has good effect in treatment of acute severe craniocerebral injury, and can promote patients awake, and also can improve prognosis, which has a certain clinical application value.