盐酸纳洛酮在重型颅脑损伤后迁延性昏迷治疗中的应用

Application of naloxone hydrochloride in the treatment of persisting coma after severe craniocerebral trauma

目的:观察应用盐酸纳洛酮治疗重型颅脑损伤后迁延性昏迷患者的临床疗效。方法:将复旦大学附属华山医院永和分院2003年11月-2007年11月收治的98例重型颅脑损伤后迁延性昏迷患者用分层随机法分成两组,对照组给予常规治疗,盐酸纳洛酮组给予常规治疗和盐酸纳洛酮治疗。观察患者生命体征、脑血流动力学、格拉斯哥昏迷量表(GCS)评分、远期生活质量评估量表(KPS)评分的变化,并对数据进行统计学处理。结果:在治疗1个月、2个月、3个月后,盐酸纳洛酮组脑血流动力学Vs和Vm值,GCS评分明显高于对照组(P<0.05);在治疗6个月后,KPS评分明显高于对照组(P<0.05)。结论:盐酸纳洛酮能够改善重型颅脑损伤后迁延性昏迷患者的脑血流动力学紊乱,提高GCS评分和KPS评分,改善患者预后。

Objective： To observe the clinical efficacy of naloxone hydrochloride in the treatment of patients with persisting coma after severe cranioeerebral trauma. Methods： A total of 98 patients with persisting coma after severe craniocerebral trauma were treated in Yonghe Branch of Huashan Hospital affiliated to Fudan University during November 2003-November 2007 were divided into 2 groups by stratified sampling method at random： naloxone hydroehloride group was treated with conventional therapy and naloxone hydroehloride, control group was treated only with conventional therapy. The vital signs,cerebral haemodynamics, Glasgow coma scale （GCS） scores and Long-term Quality of Life Assessment Scale （KPS） scores were observed and all the data were analyzed statistically. Results： Vs and Vm in cerebral haemodynamics and GCS scores were higher obviously in naloxone hydrochloride group than those in control group after one-month, two-months and three-months of treatment （P〈0.05）. KPS scores were higher obviously in naloxone hydrochloride group than those in control group six months after treatment （P〈0.05）. Conclusion： Naloxone hydrochloride can modulate the disturbance of cerebral haemodynamics, elevate the GCS score and KPS score and improve prognosis of patients with persisting coma after severe craniocerebral trauma.