高压氧联合醒脑静注射液治疗颅脑创伤后脑梗死疗效观察

Curative effect of hyperbaric oxygen combined Xingnaojing injection for treatment of cerebral infarction after traumatic brain injury

目的观察高压氧联合醒脑静注射液治疗颅脑创伤（TBI）后脑梗死的疗效，寻求治疗TBI后脑梗死的最佳方案。方法采用前瞻性研究方法，将27例TBI合并脑梗死患者按人院顺序和是否选择高压氧治疗分为治疗组（15例）和对照组（12例）。治疗组采用高压氧（220kPa）联合醒脑静注射液3ml静脉滴注，每日1次，疗程为20d；对照组只应用醒脑静注射液治疗。治疗20d后评价两组患者的神经功能缺损程度评分（NDs）、血液流变学指标及临床疗效的变化。结果治疗组和对照组治疗后患者的NDS（分）均降低，且治疗组较对照组降低更明显（10．72±2．92比15．10±5．41，P〈0．05）。治疗组治疗后血液流变学各指标均较治疗前显著降低，对照组变化无统计学意义（均P〉0．05），且治疗组全血低切黏度（mPa·s）、全血高切黏度（mPa·s）、血浆黏度（mPa·s）下降程度较对照组更显著（全血低切黏度：7．03±1．69比8．28±1．56；全血高切黏度：5．82±0．96比6．95±1．20；血浆黏度：1．45±0．22比1．69±0．37，均P〈0．05）。治疗组总有效率明显高于对照组（86.7％比66．7％，P〈0．05）。结论高压氧联合醒脑静注射液治疗TBI后脑梗死较单用醒脑静注射液更能显著改善患者的血液流变学指标，对脑梗死更有益处。

Objective To evaluate the efficacy of hyperbaric oxygen （HBO） combined with Xingnaojing injection in cerebral infarction after traumatic brain injury （TBI） to look for a proper therapy for this disease. Methods A prospective study was conducted. According to the sequence of admission into the hospital and whether the patient being necessary to use HBO, 27 patients with cerebral infarction after TBI were divided into treatment group （15 cases） and control group （12 cases）. The treatment group was treated by HBO （220 kPa） combined with intravenous drip of Xingnaojing injection, 3 ml once a day, and the control group was treated by Xingnaojing injection alone. The changes of neurologic function deficit score （NDS） and hemorrheology indexes, and clinical therapeutic effects in the two groups were assessed after treatment for 20 days. Results The NDS was significantly improved in treatment group and control group, and the NDS in treatment group was more significantly improved （10.72±2.92 vs. 15.10±5.41, P〈0.05）. The hemorrheological indexes of low-shear blood viscosity （BVL, mPa·s）, high-shear blood viscosity （BVH, mPa·s）, and plasma viscosity （PV, mPa·s） in the treatment group were decreased significantly after treatment, There were no distinguished difference in control group （all P〉 0.05）. And above indexes in treatment group were more significantly decreased as compared with those the control group （BVL ： 7.03±1.69 vs. 8.28±1.56, BVH ： 5.82±0.96 vs. 6.95±1.20, PV ： 1.45±0.22 vs. 1.69±0.37, all P〈 0.05）. The total effective rate of treatment group was higher than that of control group （86.7% vs. 66.7%, P〈 0.05）. Conclusion HBO combined with Xingnaojing injection for treatment of cerebral infarction after TBI could improve more obviously the hemorheology of the patients compared with Xingnaojing injection alone, therefore it is more beneficial to the cerebral infarction.