早期大剂量纳络酮治疗高血压脑出血的临床研究

目的　观察早期应用大剂量纳络酮 ,对高血压脑出血的治疗作用。方法　 47例高血压脑出血患者随机分成纳络酮治疗组 (n =2 5)和对照组 (n =2 2 ) ,观察早期血压的变化 ,1 0d时患者的颅内压、脑水肿带、GCS、及远期疗效 ,并进行统计分析。结果　治疗早期两组血压变化无明显差异 (P >0 .0 5) ,纳络酮治疗组颅内压明显增高和重度脑水肿者比对照组显著减少 (P <0 .0 1 ) ,治疗 1 0天后 ,治疗组意识恢复清醒率 (48.0 % )高于对照组 (2 7.3 % )(P <0 .0 5) ,3个月恢复良好率明显高于对照组 ,且重残率明显减少 (P <0 .0 5)。结论　早期大剂量纳络酮治疗高血压脑出血 ,能降低颅内压上升的幅度、减轻脑水肿 ,并且具有促醒、减少致残率 ,促进神经功能恢复的作用

A clinical trial of the efficacy and safety of high-dose naloxone at the early stage of cerebral hemorrhage secondary to hypertension

Objective To testify the efficacy and safety of high dose naloxone (NLX)in treatment of hypertensive cerebral hemorrhage(HCH)at early stage. Methods A randomized retrospective clinical trial of 47 patients with HCH(25 cases were treated with NLX and 22 cases were served as control)was done. The mean blood pressure(BP) on the first 3 days,intracranial pressure(ICP),and brain edema belt,and Glasgow coma scale(GCS)on the tenth day were the index of assessments. Glasgow outcome scale in the third month was measured for patient's prognosis. Data were statistical analyzed. Results After treatment of NLX for 3 days,BP had no significant difference between NLX group and control( P >0.05). CT scanning and lumber puncture showed that the severity of brain edema and ICP were less notable( P <0.01). More patients revived in NLX group than in control(12versus 6, P <0.01)on the tenth day accompanied by higher recovery( P <0.05) and lower disability rate( P <0.05) after three months. Conclusion Thus data have confirmed that early application of high dose NLX in treatment of HCH significantly relieve brain edema and inhibite raised ICP. It also improves the recovery of coma and reduces morbidity without side effects.