纳络酮与醒脑静注射液联合治疗重型颅脑损伤疗效观察

Effects on Naloxone(纳络酮) and Xingnaojing(醒脑静) injection in severe craniocerebral injury

目的 :探讨纳络酮注射液与醒脑静注射液联合用药在治疗重型颅脑损伤中的效果。方法 :5 9例重型颅脑损伤患者随机分为纳络酮与醒脑静注射液治疗组 (n=30 )及对照组 (n=2 9) ,观察两组患者的生命体征变化及意识情况、格拉斯哥昏迷评分 (GCS)的变化以及治疗 3个月后格拉斯哥预后评分 (GOS)情况。结果 :纳络酮与醒脑静注射液治疗组觉醒时间平均为 (8.12± 3.6 5 ) d,较对照组 (12 .4 2± 3.82 ) d明显减少 (P<0 .0 1)。治疗组伤后 10 d的 GCS评分〔(10 .5 2± 3.4 3)分〕明显高于对照组〔(8.32± 4 .0 4 )分 ,P<0 .0 5〕,伤后 3个月 GOS评分亦明显高于对照组〔(4.5 2± 2 .0 2 )分比 (3.6 8± 2 .15 )分 ,P<0 .0 5〕。结论 :纳络酮与醒脑静注射液联合用药能明显缩短患者昏迷时间 ,降低伤残及病死率 ,促进患者神经功能恢复 ,其机制可能与拮抗伤后β内啡肽释放及改善脑组织微循环 ,抑制脑循环中微血栓的形成有关。

Objective:To study the therapeutic effect of Naloxone(NLX,纳络酮) and Xingnaojing(XNJ, 醒脑静 ) injection used united in treatment for severe craniocerebral injury.Methods:fiftynine patients with severe craniocerebral injury were randomly divided into two groups,NLX and XNJ therapeutic group( n =30) and control group( n =29).The changes of patients′ life symptom,consciousness,Glasgow coma scale(GCS) and Glasgow outcome scale(GOS) three months later were observed.Results:The average anabiosis time of therapeutic group〔(8 12±3 65)days)〕 was significantly shorter than control group〔(12 42±3 82)days, P <0 05 〕.The GCS postburn ten days(10 52±3 43) was significantly higher than control group(8 32±4 04, P <0 05).The GOS was significantly higher than control group too(4 52±2 02 vs.3 68±2 15, P <0 05 ) three months later.Conclusion:The united use of NLX and XNJ injection can significantly shorten the coma time,take down the deformity and mortality.And it can do help to neuro function resume.It may antagonize the release of βendorphin(βEP) after been injured,improve cerebral microcirculation and restrain microthrombosis in cerebrum by any possibility.