大剂量甲强龙治疗特重型颅脑损伤临床分析

目的:探讨大剂量甲基强的松龙(甲强龙)治疗特重型颅脑损伤的疗效和安全性。方法:选择伤后6h内入院的特重型颅脑损伤(GCS评分3～5min)患者43例(实验组)接受大剂量甲强龙治疗,同期入院使用地塞米松但未使用甲强龙治疗的同类患者43例作为对照组;所有患者其他治疗措施均基本相同。结果:将恢复良好、中残、重残合称为治疗有效,将植物生存、死亡合称为治疗无效,甲强龙实验组治疗有效21例(占48.8％),无效22例(占51.2％),有效组觉醒天数为(19.3±5.6)d(n=21);对照组分别为12例(占27.9%)及31例(占72.1%),觉醒天数为(26.2±7.8)d(n=12)。两组比较均有显著性差异(P<0.05或P<0.01)。结论:特重型颅脑损伤患者早期应用大剂量甲强龙治疗可明显提高临床疗效,缩短昏迷时间,无增加毒副作用,值得临床推广应用。

Clinical Study of High-dose Solu-Medrol in Treatment of Special Severe Brain Injuries

Objective:To study the effect and safety of early use of high-dose Solu-Medrol on special severe brain injuries.Methods: All 86 patients with special severe brain injuries (Glasgow coma scale score of 5 or less on admission)were randomly divided into the experiment group (43 cases ) and the control group (43 cases ) .The experiment group were treated by high-dose Solu - Medrol and the control group treated by dexamethasone. Results: The results showed that 21 cases were treated effectively and 22 cases treated effectless in the experiment group while to the control group, 12 and 31 cases respectively;There were significant difference between two groups( P < 0.05) .The time of awakening and conscious recovery in the experiment group were shorter than that in control ( P < 0.01) .Conclusions:The effect of patients with special severe brain injuries can be improved by administration of high-dose Solu-Medrol and it deserves further clinical applications.