尼莫地平治疗重型颅脑损伤后对脑组织氧分压的影响

Effect of nimodipine on severe head injures through monitoring brain tissue PO_2

目的研究尼莫地平对重型颅脑损伤患者脑组织氧分压(PbtO2)的影响。方法重型颅脑损伤患者30例,分为对照组和尼莫地平组,对照组采用常规治疗,尼莫地平组除常规治疗外,于24小时内加用尼莫地平。两组均持续监测PbtO2,并对不同时段PbtO2进行统计分析,对每例患者于伤后3个月行GOS评分并对两组患者预后进行比较。结果尼莫地平组和对照组患者入院时、治疗8小时时段PbtO2无显著差异(P>0.05),但尼莫地平组在治疗24小时4、8小时、72小时时段PbtO2均高于对照组(P<0.05),伤后3个月GOS评分显示尼莫地平组预后优于对照组。结论重型颅脑损伤早期应用尼莫地平可改善脑的血液循环,减轻继发性脑损伤,促进功能恢复,降低患者死亡率。PbtO2监测是一种较为理想的近期病情监测手段。

Objective To study the influence of nimodipine for severe head injury though monitoring and analyzing the changes of brain tissure PO2 in patients with severe head injury.Methods 30 patients with severe head injury were selected for this study.Control group received ordinary treatment,nimodipine group received nimodipine in addition.PbtO2 and ICP in all patients were continuously monitored.Results There are no differences in PbtO2 between severe head injury patients in both groups before treatment,8 hours after treatment（P〉0.05）,PbtO2 was higher in nimodipine group than that in control group at 24 hours,48 hours,72 hours after treatment（P〈0.05）.Conclusion Nimodipine is effective to the patients with severe head injury.PbtO2 monitoring could estimated the effect of treatment and prognosis in severe head injury.