纳洛酮治疗39例重度颅脑损伤的临床效果观察

Observation on clinical effect of application of naloxone in treatment of severe craniocerebral injury-39 cases study

目的观察并探讨重度颅脑损伤患者术后早期静脉泵注大剂量纳洛酮的临床效果。方法将我院2010年10月至2012年2月间收治的85例重度颅脑损伤患者随机分为观察组与对照组,对照组(42例)行手术与常规对症治疗,观察组(43例)在此基础上术后微量泵持续静脉泵注纳洛酮0.4mg/(kg·d),疗程2周,对比不同时点两组患者Glasgow评分与2周后脑水肿改善情况。结果①术后观察组、对照组患者病死率分别为9.3%、16.7%;②治疗1周、2周后观察组Glasgow评分均高于对照组(P<0.05);③2周后观察组、对照组脑水肿改善构成情况不同(P<0.05),总体有效率分别为97.4%、87.9%。结论重度颅脑损伤患者术后早期大剂量静脉输注纳洛酮可提高手术成功率,改善临床预后。

Objective To have an observation on clinical effect of application of naloxone in treatment of severe craniocerebralinjury. Methods 85 severe craniocerebral injury cases ranging from Oct. 2010 to Feb. 2012 were randomized into observational and control group, 42 cases in control group adopted conventional symptomatic treatment, based on which,43 cases in observational group were given naloxone treatment by intra- venous micro-dosage pump 0.4 mg/（ kg · d） ,2 weeks for 1 period of treatment, and comparative study was con- ducted on Glasgow mark and improvement of cerebral edema of different observational points. Results （1）Post- operative mortality of observational and control group were 9. 3% , 16.7% respectively. （2）Glasgow mark of ob- servational group after 1 ＆ 2 treatment schedule were superior to control group （ P 〈 0.05 ）. （3）Improvement of cerebral edema of 2 groups was different （P 〈 0. 05 ）, overall effective rate of 2 groups were 97.4%, 87.9% re- spectively. Conclusion Earlier application of high dose naloxone through intravenous trace in treatment of se- vere craniocerebral injury can be effective in escalating success rate and improving clinical prognosis.