甘露醇开放血脑屏障后应用神经生长因子对重型颅脑损伤治疗的研究

The Curative Effects of Nerve Growth Factor in Serve Brain Injury After Opening the Blood Brain Barrier with the Venous Rapid Drip of Mannitol

目的:观察甘露醇开放血脑屏障后应用神经生长因子(NGF)局部注射促进重型颅脑损伤患者预后的效果。方法:将368例重型颅脑损伤患者随机分为对照组、治疗组和特殊治疗组。对照组给予常规神经外科治疗;治疗组在对照组基础上给予神经生长因子12μg肌注,1次/d,连续15d;特殊治疗组在肌注神经生长因子12μg后20min即快速静注20%甘露醇250ml,连续15d。以三组患者3个月后GOS评分为预后观察指标对三组患者恢复情况作出对比分析。结果:三组病例均获随访,经统计学处理,治疗组疗效优于对照组(P<0.05),特殊治疗组疗效优于对照组和治疗组(P<0.05)。结论:甘露醇开放血脑屏障后应用神经生长因子(NGF)能提高外源性神经生长因子的疗效,对改善重型颅脑损伤患者预后能起到较为明确的作用。

Objective ： To investigate the curative effects of nerve growth factor（NGF） in serve brain injury after opening the blood brain barrier with the venous rapid drip of mannitol. Methods ： 368 patients with severe brain injury were divided into three groups ： control group, common NGF treatment group, and special NGF treatment group. The patients in common NGF group were treated with NGF intramuscular injection, and the other treatment was the same as that of the control group. The special NGF treatment used mannitol to open the blond brain barrier before NGF intramuscular injection. The clinical data, changes of GOS in patients of these three groups were observed and compared with. Results ： According to GOS scoring of the tracking investigation in three months after injury, the score in patients of common NGF treat group had been remarkably higher than that of control group（P〈0.05）, and the score of special NGF treat group GOS was significantly higher than that of common NGF group（P〈0.05）. There were no obvious adverse reactions observed. Conclusion ： Early application of NGF after opening the blood brain barrier with the venous rapid drip of mannitol can significantly accelerate the recovery of nervous function, and improve the prognosis of patients with severe brain injury.