亚低温与醒脑静注射液治疗急性重型颅脑创伤的疗效分析

The Clinical Effect of Mild Hypothermia and Xingnaojing Injection on Severe Brain Injury

目的探讨亚低温与醒脑静注射液在急性重型颅脑损伤中的治疗效果。方法157例急性重型颅脑创伤病人,随机分为亚低温组(54例)、亚低温加醒脑静组(48例)和常规治疗组(55例)。治疗后3个月根据格拉斯哥预后评分(GOS)标准判定疗效。对于除植物生存和死亡以外的101例病人,同时采用Barthel指数,治疗后3个月评估病人的日常生活活动(ADL)能力。同时观察治疗过程中3组病人的并发症等情况。结果亚低温组和亚低温加醒脑静组的病死率和常规治疗组相比有统计学意义(P<0.05),二者之间差异不明显(P>0.05)。3组的恢复良好率均有统计学意义(P<0.05),亚低温加醒脑静组良好率最高。在凝血功能异常上,常规治疗组和其余两组相比差异有统计学意义(P<0.01)。常规治疗组的凝血功能异常较少。亚低温组和亚低温加醒脑静组的Barthel指数分别和常规治疗组相比差异有统计学意义(P<0.01),亚低温和亚低温加醒脑静组的Barthel指数相比亦有统计学意义(P<0.01)。结论应用亚低温治疗急性重型颅脑创伤可降低病人病死率,同时给予醒脑静注射液可以提高病人恢复良好率,二者结合的疗法是一种有希望的颅脑外伤综合治疗措施。

Objective To assess the clinical effects of mild hypothermia and Xingnaojing injection on severe brain injury, Methods All 157 patients with acute severe brain injury were divided into mild hypothermia group （54 pts）, Xingnaojing with mild hypothermia group （48 pts） and routine treatment group （55 pts） randomly, The therapeutic effect was evaluated at the 3rd month after injury by Glascow Outcome Scale. One hundred and one pts （vegetable alive and dead pts were not included） were evaluated at the 3rd month after injury by Barthel Index. Side effects were also observed. Results In comparison with other two groups, there was a higher mortality rate in routine treatment group （P〈 0.05）. There were significant difference for recovery rate in three groups （P〈 0. 05）, Dysfunction of cruor was sig- nificantly severer in two mild hypothermia groups than that in routine treatment group （P〈 0.01 ）. Conclusion Mild hypothermia was an effective way to severe brain injury, it could reduce the mortality rate and improve the prognosis without severe complications. The Xingnaojing injection had some effect for recovery.