β-七叶皂苷钠治疗高温高湿环境下重型颅脑伤的疗效观察

Clinical effect of β-aesdne sodium on severe head injury in hot and humid environment

目的探讨β-七叶皂苷钠治疗高温高湿环境下重型颅脑伤的效果。方法高温高湿环境（气温≥35℃,相对温度≥80%）下,100例重型颅脑损伤患者随机分成β-七叶皂苷钠治疗组（50例）和对照组（50例）,观察治疗早期患者生命体征、颅内压（ICP）、头颅CT、经颅多普勒（TCD）变化和远期疗效,对两组结果进行比较。结果治疗组,早期患者呼吸循环较快恢复稳定,呼吸异常率26%,心律异常率26%;伤后10d颅内压显著升高率和重型脑水肿率与对照组比较均明显减少（P＜0．01）;治疗组TCD结果血流速度接近正常;伤后6个月恢复良好率显著高于对照组（P＜0．05）,重残及死亡率明显低于对照组（P＜0．05）。结论β-七叶皂苷钠可以降低高温高湿环境下重型颅脑伤患者颅内压升高幅度,缩短昏迷时间,降低伤残率,促进患者神经功能恢复,改善预后,使用安全,治疗过程中未见副作用。

Objective To investigate clinical effect of β-aescine on severe head injury in hot and humid environment（ air temperature ≥35℃ ,relative humidity ≥80% ;HHE）. Methods One hundred patients with severe head injury in the HHE were randomly divided into two groups： 50 cases treated with β-aescine sodium in treatment group, the other 50 cases in control group. In the cause of early treatment, the data of vital signs, ICP, CT scanning, TCD of patients and prospective efficacy were compared between both groups. Results In the initial stage, breath of patients recovered sooner in β-aescine group. And rate of abnormal respiration was the same 26 per cent as that of arrhythmia. On the 10th day after injury, both rates of increased intracranial pressure and severe brain edema were less significantly in treatment group than those in control group （P 〈 0.01 ） . Moreover, TCD spectral form and blood flow speed in treatment group were similar to normal. After six months, more patients revived in treatment group, accompanied by significantly higher recovery rate （ P 〈 0.05 ） and significantly lower severe disability rate and death rate （ P 〈 0.05 ） than those in control group. Conclusions The present study showed, that by use of a successive early large dosage of β-aescine sodium,increased intracranial pressure could be relieved and time of coma could be shorten and disability rate could be reduced and nerve function recovery could be improved in patients with acute severe brain injuries in the HHE. The approach is safe and no side effect.