纳美芬治疗急性重型颅脑创伤的疗效分析

Clinical study of nalmefene in treatment of acute severe traumatic brain injury

目的探讨乐萌(盐酸纳美芬)在急性重型颅脑创伤救治中的疗效及其机制。方法 122例急性重型颅脑创伤患者随机分成纳美芬治疗组(62例)和对照组(60例),观察治疗患者生命体征、意识觉醒恢复时间、颅内压(ICP)、经颅多普勒(TCD)检查和远期疗效。结果纳美芬治疗组生命体征较快恢复稳定、意识觉醒恢复时间缩短I、CP增高和脑血流速度方面较对照组降低、GCS评分明显升高,伤后3个月恢复良好率显著高于对照组,重残及病死率明显减少。结论纳美芬能有效改善急性重型颅脑创伤患者的临床症状,缩短昏迷时间,降低急性重型颅脑创伤患者颅内压的升高幅度,降低伤残率,促进患者神经功能恢复,改善预后。

Objective To access clinical effects of nalmefene in treatment of acute severe traumatic brain injury and its mechanism.Methords Totally 122 patients of acute severe traumatic brain injury were randomly assigned to the nalmefene treatment group（n=62） and the control group（n=60）,to observe the vital signs of patients,the consciousness and intracranial pressure（ICP）,transcranial doppler（TCD） and long-term effect.Results ①The vital signs of the nalmefene treatment group was more quickly stabilized.②The time of awakening and conscious recovery in treatment group were shorter than those in the control group.③ICP and the speed cerebral blood flow was decreased than that of the control group.④GCS score was significantly higher.⑤The good recovery rate was significantly higher than that of the control group 3 months after injury.⑥The severe disability and mortality was significantly reduced.Conclusions Nalmefene can improve clinical symptoms in patients of acute severe traumatic brain injury,shorten the duration of coma,reduce the increase rate of ICP,reduce the disability rate,promote recovery of neurological function and improve prognosis.