早期应用纳洛酮治疗急性重症颅脑损伤

目的 观察早期应用纳洛酮对急性重症颅脑损伤的临床疗效及对改善预后的影响.方法 62例急性重症颅脑损伤患者按就诊顺序分为治疗组30例和对照组32例,所有患者均给予脱水剂、镇静类、钙离子拮抗剂等药物,以及吸氧、支持、亚低温冬眠和抗感染治疗.治疗组除采用以上常规处理外,均在入院后6 h内应用纳洛酮,剂量为0.4 ms/(kg·d),生理盐水稀释至500 ml,用输液泵24 h持续静脉输入,3 d后改为0.1 mg/(kg·d),7 d后停药,观察2组患者生命体征、格拉斯哥昏迷量表评分、觉醒时间、呼吸衰竭纠正时间,并进行统计学分析.参考格拉斯哥预后量表判断预后.结果 治疗组恢复良好10例(33.3%),死亡7例(23.3%),觉醒时间为(7.6±4.5)d,呼吸衰竭纠正时间为(6.6±3.7)d;对照组恢复良好7例(21.9%),死亡12例(37.5%),觉醒时间为(10.4±4.72)d,呼吸衰竭纠正时间为(9.9±4.1)d,2组差异均有统计学意义(P<0.05或P<0.01).结论 早期使用纳洛酮可降低急性重型颅脑损伤的致残率、病死率,减轻脑水肿,促使脑神经功能恢复,改善生活质量.

Naloxone in treatment of severe craniocerebral trauma

Objective To evaluate the efficacy of early application of Naloxone for treatment of severe craniocerebral trauma. Methods Sixty-two patients with severe craniocerebral trauma were divided into two groups: 30 cases were treated with naloxone and a control group of 32 cases without Naloxone. The clinical data, Glasgow coma scale(GCS) evaluation, consciousness recovery and respiratory failure recovery were observed. Results In treatment group, 10 cases(33.3%)recovered and 7 cases (23.32%)were dead. In controlled group there were 7 recovery (21.9%)and 12 death(37.5%). The recovery of consciousness and the recovery of respiratory failure in Naloxone group were also statistically lower than those in controlled group (P < 0.05). Conclusion Early applica-tion of Naloxone for severe craniocerebral trauma significantly reduces morbidity and mortality and improves the re-spiratory failure recovery.