纳洛酮治疗原发性脑干损伤

目的 :观察纳洛酮治疗原发性脑干损伤的疗效。方法 :83例原发性脑干损伤病人分为纳洛酮组 38例 ,在常规治疗基础上加用纳洛酮 0 .3mg·kg- 1加入氯化钠注射液 5 0 0mL中静脉滴注 ,qd× 3d ,3d后减为 4 .8mg·d- 1,qd× 7d ,10d为一个疗程 ;常规治疗组 4 5例 ,单用常规治疗。按格拉斯哥昏迷评分标准观察病人症状。结果 :常规治疗组和纳洛酮组的昏迷时间分别为 (30±s 4 )d和 (2 0±4 )d ,死亡分别为 16例和 6例 ,恢复良好分别为 12例和 2 3例 ,中残分别为 7例和 6例 ,重残分别为 10例和 3例、植物生存各 1例 ;2组昏迷时间及疗效比较 ,P <0 .0 1。结论 :纳洛酮在原发性脑干损伤的治疗中能降低死亡率 ,缩短昏迷时间 ,减少残存率。

Naloxone in treatment of primary brain-stem injury

AIM: To observe the efficacy of naloxone treatment of primary brain-stem injury. METHODS: Eight-three patients with primary brain-stem injury were divided into naloxone group(38 patients ) and conventional treatment group(45 patients). Naloxone group was treated with naloxone 0.3 mg·kg -1in sodium choride injection 500 mL,iv,gtt,qd×3 d. After 3 d that was reduced to 4.8 mg·d -1,qd×7 d besides the conventional treatinent. The conventional treatment group received conventional treatment only.The patients' symptoms were observed by Glasgow Coma Scale(GCS). RESULTS: The time of stupor was (30±s 4)d and (20±4) d in conventional treatment group and naloxone group, respectively. The patients died were 16 and 6. The patients revive well were 12 and 23. The middle handicapped patients were 7 and 6, the severe handicapped patients were 10 and 3. The living as persistent vegetative state(PVS) patients was 1 and 1, respectively. There was significant difference in time of stupor and efficacy between two groups, P<0.01. CONCLUSION: Naloxone can diminish mortality, decrease the stupor time and cut down the disability rate in the treatment of primary brain-stem injury.