纳洛酮及神经节苷脂治疗重型颅脑损伤的临床观察

目的:探讨纳洛酮(NLX)及神经节苷脂(GM1)在重型颅脑损伤中的运用效果及其机制.方法:将76例急性重型颅脑损伤病人随机分成NLX及GM1治疗组(n=40)和对照组(n=36),观察治疗时期病人的生命体征、颅内压、头颅CT变化和远期疗效.结果:NLX及GM1治疗组病人呼吸循环较快稳定,呼吸异常(15%)、心律导异常(20%)及伤后1周颅内压显著升高(20%)和重度脑水肿者(20%)均较对照组明显减少(P＜0.01);NLX及GM1治疗组1周后意识转清醒率(35%)及伤后3个月恢复良好率(45%)显著高于对照组(P＜0.01),重残及死亡率(25%)明显减少(P＜0.01).结论 NLX及GM1治疗组可以降低重型颅脑损伤病人颅内压的升高幅度,缩短昏迷时间,降低伤残率,促进病神经功能恢复,改善预后,提高恢复良好率

Clinical Use of NLX and GM1 for Acute Severe Brain Injuries

Objectives:To discus the clinical effects and mechanism of NLX and GM1 for acute severe brain injuries. Methods:A total of 76 patients with acute severe traumatic head injury were divided into two groups randomized(40cases were treated with NLX and GM1 and 36 cases were control). The clinical data, neurological outcome after treatment were observed . Results:The fluctuation of vital signs in the first 3 days was smooth in NLX and GM1 group than than in control ,including arrhythmia(P<0.01)and abnormal respiration(P<0.01).CT scanning and lumdar puncture showed that the severity of brain edema and increase of intracranial pressure was less remarkable(P<0.01), After treatment of NLX and GM1 for one week . More patients revived in NLX and GM1 group than that in concra(lP<0.05)in 7days accompanied by higher recovery rate(P<0.05)and lower disability(P<0.05)after three months . Conclusions: A successive early large dosage of NLX and GM1 could relieve traumatic brain edema and improve the rccouery of coma and reduce the disability in acute severe brain injuries.