盐酸纳洛酮治疗急性中、重型脑外伤临床研究

目的　探讨盐酸纳洛酮对急性中重型脑外伤患者的治疗作用。方法　将 4 0例急性脑外伤患者随机分为盐酸纳洛酮治疗组 (治疗组 )和胞二磷胆碱治疗组 (对照组 ) ,每组 2 0例。所有患者药物治疗均在脑外伤后 1 2h内 ,在脱水、抗炎、神经营养等常规治疗基础上 ,治疗组加用盐酸纳洛酮 4 .0mg/d ,连续 1 4d为 1疗程。对照组则加用胞二磷胆碱静脉滴注 0 .75g/d。依据意识觉醒时间、GCS评分、GOS评分及TCD等 ,比较两组患者病情恢复情况。结果　急性中、重型脑外伤治疗中 ,治疗组在意识觉醒时间上与对照组相比具有明显统计学意义 (P <0 .0 5 ) ;在不同时期GCS评分上 ,治疗组与对照组相比亦具有明显统计学差异 (P <0 .0 5 ) ;GOS评分治疗组预后明显优于对照组 ,具有非常明显统计学意义 (P <0 .0 1 )。TCD结果显示治疗组缓解脑血管痉挛效果优于对照组。结论　急性脑外伤早期应用盐酸纳洛酮可明显降低颅脑损伤的病残程度 ,提高治疗效果。

A Clinical Study on Treating Acute Moderate and Severe Craniocerebral Trauma by Naloxone

Objective To explore the therapeutic effects of Naloxone on acute moderate and severe craniocerebral trauma.Methods 40 patients with acute craniocerebral trauma were randomly divided into two groups:namely,Naloxone and control groups,each with 20 cases.Both groups were received the standard therapy,meanwhile the 20 cases in Naloxone group were administrated 4.0 mg/d Naloxone for two weeks intravenously and 0.75 g/d Citicoline was administrated in control group.According to awakening time,GCS scores,GOS evaluation and TCD,to analyze the different prognosis between two groups.Results There was a significant difference on awakening time between Naloxone group and control group in patients with acute craniocerebral trauma(P<0.05);There was a significant difference on GCS scores between two groups(P<0.05);the prognosis of the Naloxone Group was better than that of control group(P<0.01);the CVS was improved greater in Naloxone Group than that in control group by TCD examination.Conclusion The rate of death and disability can be decreased,and the therapeutic effects can be improved by the administration of Naloxone in patients with acute brain injury.