尼莫地平联合高压氧治疗弥漫性轴索损伤的临床研究

目的探讨尼莫地平联合高压氧治疗弥漫性轴索损伤的疗效。方法将176例弥漫性轴索损伤患者按随机数字表法随机分为4组:对照组(常规治疗),尼莫地平组(常规治疗+尼莫地平联合治疗),高压氧组(常规治疗+高压氧联合治疗),联合治疗组(常规治疗+尼莫地平+高压氧联合治疗),于伤后第1、4、8、15、22天采用经颅多普勒超声(TCD)测定所有患者双侧大脑中动脉及颈内动脉颅外段血流速度;分别于伤后当天,治疗后1、8、15、22d行GCS评分及治疗半年后行GOS评分,并互相比较。结果治疗22d后,联合治疗组患者GCS评分明显提高(P<0.01),预后良好率均明显高于其他三组(P<0.05),且联合治疗组脑血管痉挛明显改善。结论尼莫地平联合高压氧治疗有助于改善弥漫性轴索损伤患者的预后。

Clinical research of treatment of diffuse axonal injury with nimodipine combined with hyperbaric oxygen

Objective To observe the curative effect of nimodipine combined with hyperbaric oxygen on diffuse axonal injury （DAI）. Methods One hundred and seventy-six patients with DAI were randomly divided into four groups, i.e. routine treatment （control） group, nimodipine treatment group （the treatment with the routine method combined with nimodipine）, hyperbaric oxygen group （the treatment with routine method combined with hyperbaric oxygen） and the combined treatment group （the treatment with nimodipine combined with hyperbaric oxygen and routine method）. GCS was observed before and after the treatment and compared among each other. GOS was determined 6 months after the treatment in all the groups. The blood flow velocities of bilateral middle central artery （MCA） and extracrnial portion of the internal carotid artery （ICA） were monitored by transcranial Doppler ultrasonography （TCD） 1, 4, 8, 15 and 22 days respectively after the treatment. Results The scores of GCS were significantly higher in the combined treatment group than those in the other groups 22 days after the treatment （P0.05）. The mean velocities of MCA blood flow were significantly slower in the combined treatment group than those in the other groups 4, 8, and 15 days after the treatment （P0.05）. The good rate of the prognosis was significantly higher in the combined treatment group than that in the other groups 6 months after the treatment. Conclusion The treatment with nimodipine combined with hyperbaric oxygen on the basis of routine treatment can improve the prognoses in the patients with DAI.