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[摘要]
目的 探討納洛酮聯合小牛血清去蛋白治療急性顱腦損傷的臨床效果。方法 選取2015年8月—2017年8月重慶市開州區(qū)人民醫(yī)院收治的急性顱腦損傷患者122例,隨機分為對照組(61例)和治療組(61例)。對照組靜脈滴注小牛血清去蛋白注射液,30 mL加入5%葡萄糖注射液250 mL,1次/d。治療組在對照組基礎上靜脈滴注鹽酸納洛酮注射液,0.3 mg/(kg∙d)。兩組患者均連續(xù)治療7 d。觀察兩組臨床療效,比較治療前后兩組格拉斯哥昏迷量(GCS)評分、血液流變學指標、及腫瘤壞死因子(TNF)-α、IL-6和神經元特異性烯醇化酶(NSE)水平。結果 治療后,對照組和治療組臨床總有效率分別為78.7%、93.4%,兩組比較差異具有統計學意義(P<0.05)。治療后,兩組GCS評分中運動、語言、睜眼及GCS總評分均顯著升高(P<0.05);且治療組GCS評分明顯高于對照組(P<0.05)。治療后,兩組全血黏度(WBV)、血漿黏度(PV)和紅細胞聚集指數(EAI)值均顯著下降(P<0.05);且治療組比對照組降低的更顯著(P<0.05)。治療后,兩組血清TNF-α、IL-6、NSE水平均明顯降低(P<0.05);且治療組比對照組降低的更明顯,(P<0.05)。結論 納洛酮聯合小牛血清去蛋白治療急性顱腦損傷可迅速緩解患者癥狀體征,減輕炎性損傷,改善神經功能,具有一定的臨床推廣應用價值。
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[Abstract]
objective To investigate the clinical effect of naloxone combined with bovine serum albumin in treatment of acute craniocerebral injury. Methods Patients (112 cases) with acute craniocerebral injury in the People's Hospital of Kaizu District,CQ from August 2015 to August 2017 were randomly divided into control (61 cases) and treatment (61 cases) groups. Patients in the control group were iv administered with Deproteinised Calf Blood Serum Injection, 30 mL added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were iv administered with Naloxone Hydrochloride Injection on the basis of the control group, 0.3 mg/(kg∙d). Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the GCS score, hemorheological indexes, and TNF-α, IL-6, NSE levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.7% and 93.4%, respectively, and there were differences between two groups (P < 0.05). After treatment, the motion, language, eyes open and total GCS scores in two groups were significantly increased (P < 0.05). And the GCS scores in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the WBV, PV, EAI levels in two groups were significantly decreased (P < 0.05). And the hemorheological indexes in the treatment group decreased more significantly than those in the control group (P < 0.05). After treatment, the TNF-α, IL-6 and NSE levels in two groups were significantly decreased (P < 0.05). And these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Naloxone combined with bovine serum albumin in treatment of acute craniocerebral injury can rapidly relieve symptoms and signs and reduce inflammatory injury, and improve neurological function, which has a certain clinical application value.
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