溴隐停及美多巴联合治疗脑外伤后迁延性植物生存状态的临床观察

目的研究溴隐停及美多巴联合治疗创伤性脑外伤（TBI）后迁延性植物生存状态（PVS）的临床价值及使用范围。方法对一组连续46例在常规治疗的基础上加用澳隐停及美多巴治疗的PVS病人的一般临床特点和CT特征与治疗结果进行观察分析。结果TBI后的PVS最多见于交通事故性脑外伤。除大脑皮质的损伤外，弥漫性轴素损伤（DAI）、深部核团的损伤、脑干上部的损伤、以及伤后包括基底节在内的弥漫性脑萎缩是PVS的主要病理类型。运用澳隐停及美多巴后，73．9％的PVS病人的意识状态及运动功能得到改善。结论在没有广泛大脑皮质损伤，主要表现DAI和脑深部核团损伤的PVS病人，增强大脑多巴胺系统的功能对PVS病人具有治疗作用。

Clinic Study on the Combination Use of Bromocriptine and Madopa in the Therapy of the Posttraumatic Persistent Vegetative State

objective To study the clinic application and value of the combination use of bromocriptine and madopa in the treatment of the posttraumatic persistent vegetative state(PVS). Methods Since 1995. 10 ~ 1999. 2, 46 consecutive patients of posttraumatic PVS were treated with Bromocriptine and Madopa, the clinic features, the CL exhibitions, and the therapy results of which were recorded and analyzed. Results About 82. 6% of posttraumatic PVS was caused by traffic accident brain injury. In all 46 cases there was evidence of diffuse axonal injury in clinic manifestation and on CT imaging. The most conmon patern of injury was the combination of focal cortical contusion and white matter injury or upper brainstem injury. The basal ganglia or thalamus lesions were the second common injury features of PVS. The diffuse brain atrophy including basal ganglia and thalamus and brainstem can be seen in all 45 cases. Conclusions The data indicated that the diffuse axonal injury and the basal ganglia or thalamus injury may be the major form of primary brain damage in the posttraumatic PVS. Bromocriptine and Madopa can improve the consciousness state and movement function of PVS patients in some cases.