依达拉奉对颅脑损伤病人脑水肿及预后的影响

目的探讨依达拉奉对颅脑损伤病人脑水肿及预后的影响。方法采用随机双盲平行对照试验,98例急性颅脑损伤的病人随机分成治疗组50例和对照组48例,对照组按照急性脑损伤常规治疗,治疗组在常规治疗的基础上给予依达拉奉注射液30mg加入生理盐水注射液100ml中静滴,bid,共14d。2组在治疗后3、7、14、28d做头部CT检查,根据脑CT显示脑水肿最大层面的长×宽测算脑水肿面积表示脑水肿的程度,观察脑水肿的变化。于治疗前和治疗后28d分别进行格拉斯哥昏迷评分(GCS)。结果2组病人伤后脑水肿均逐渐加重而至第7d达高峰期,在第7d前2组脑水肿变化比较无统计学意义(P>0.05)。从第14～28d2组病人均明显减轻,但治疗组脑水肿减轻程度明显优于对照组(P<0.01);2组在第28dGCS评分均有提高,但治疗组GCS评分明显高于对照组(P<0.05)。依达拉奉治疗期间未发现明显不良反应。结论依达拉奉可以减轻颅脑损伤病人脑水肿,并能改善预后,无明显不良反应。

Effect and prognosis of Edaravone treating brain edema in patients with traumatic brain injury

Objective To evaluate the effect of Edaravone on brain edema and the prognosis in patients with traumatic brain injury.Methods Randomized,double-blind,parallel contrast trial was conducted.Ninty-eight patients with traumatic brain injury were divided into treatment group of 50 cases and control group of 48 cases randomly.The patients in control group received conventional therapy according to traumatic brain injury.The treatment group received conventional therapy and Edaravone injection 30 mg dissolved in sodium chloride injection 100 ml,iv drip,twice a day,for 14 days.Head CT in the two groups was checked at 3 d,7 d,14 d,28 d after treatment,brain edema area according to long multiplication wide in maximum area of head CT showed brain edema,and observed the changes of brain edema degree according to area changes of the head CT.The brain injury degree was evaluated using Glasgow coma score(GCS)in the two groups before treatment and at 28 d after treatment.Results The brain edema slowly increased in weight after injury 7 d,and reached summit at 7th day in the two groups,the brain edema difference was no statistical significant in the two groups before 7th day.The brain edema degree was obviously lighted from 14th day to 28th day in the two groups,but the brain edema degree in treatment group was lighter than in control group(P<0.01),the GCS count all was raised from 14 d to 28 d in the two groups,but the GCS count in treatment group was higher than in control group(P<0.05),the adverse reaction was not obvious with Edaravone.Conclusion Edaravone can lighten the brain edema in patients with traumatic brain injury and improve the prognosis.The adverse reaction is not evident.