醒脑静注射液联合改良去大骨瓣减压术对重型颅脑损伤患者颅内压及近期预后的影响

目的探讨醒脑静注射液联合改良去大骨瓣减压术对重型颅脑损伤患者颅内压及近期预后的影响。方法选取襄阳市中心医院2017年3月至2018年4月收治的重型颅脑损伤患者60例,随机分为观察组与对照组,各30例。两组患者入院后均予常规止血、降温、吸氧、补液、脑神经保护和降颅内压等紧急对症处理,并行改良去大骨瓣减压术,观察组加用醒脑静注射液治疗1个月。结果两组患者格拉斯哥预后量表(GOS)评级无明显差异(P>0.05);观察组患者术后颅内压恢复平稳时间均及术后住院时间明显短于对照组,格拉斯哥昏迷量表(GCS)评分明显高于对照组(P<0.05);观察组患者神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素2(IL-2)、白细胞介素6(IL-6)水平均明显低于对照组(P<0.05);观察组与对照组不良反应发生率相当(26.67%比23.33%,P>0.05)。结论醒脑静注射液联合改良去大骨瓣减压术治疗重型颅脑损伤,可加快患者颅内压的平稳恢复,改善神经组织损伤,降低炎性因子水平。

Xingnaojing Injection Combined with Modified Decompressive Craniectomy on Intracranial Pressure and Short-Term Prognosis in Patients with Severe Craniocerebral Injury

Objective To investigate the effects of Xingnaojing Injection combined with modified decompressive craniectomy on intracranial pressure and short-term prognosis in patients with severe craniocerebral injury.Methods A total of 60 patients with severe craniocerebral injury in the hospital from March 2017 to April 2018 were selected and randomly divided into the observation group and control group,30 cases in each group.After admission,the two groups were treated with emergency symptomatic treatment such as routine hemostasis,hypothermia,oxygen inhalation,fluid replacement,cerebral nerve protection,and intracranial pressure reduction;then received modified decompressive craniectomy.The observation group was added with Xingnaojing Injection for 1 month.Results There was no significant difference in the grading of Glasgow Outcome Scale(GOS)between the two groups(P>0.05).The recovery time of intracranial pressure and postoperative hospital stay in observation group were significantly shorter than those in control group,while the Glasgow Coma Scale(GCS)score was significantly higher than that in control group(P<0.05);the levels of neuron-specific enolase(NSE),myelin basic protein(MBP),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin 2(IL-2)and interleukin-6(IL-6)in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in occurrence of postoperative complications between the two groups(26.67%vs.23.33%,P>0.05).Conclusion Xingnaojing Injection combined with modified decompressive craniectomy for severe craniocerebral injury can accelerate smooth recovery of intracranial pressure,improve nerve tissue damage,and reduce inflammatory factors levels.