手术联合自体骨髓干细胞动员治疗重型颅脑损伤疗效观察

Effect of surgery plus autologous bone marrow stem cells mobilization on severe craniocerebral injury

目的观察重型颅脑损伤外科手术联合自体骨髓干细胞动员和综合康复治疗的临床效果和安全性。方法行手术治疗的重型颅脑损伤患者75例,其中38例术后接受常规神经营养和综合康复治疗者为对照组,37例在对照组治疗基础上行自体骨髓干细胞动员(G-CSF/GM-CSF联合辛伐他汀)治疗者为观察组,比较2组临床治疗效果。结果观察组神经功能缺损评分(NIHSS)(9.83±2.43)明显低于对照组(17.33±4.16)(t=3.950,P<0.01),格拉斯哥预后评分(GOS)结果明显高于对照组(χ2=10.852,P<0.05);治疗3周后观察组外周血CD34+CD133+占外周血单核细胞比率(5.92±1.36)%明显高于对照组(2.06±0.69)%(P<0.05);2组治疗过程中均未出现明显不良反应。结论外科手术联合自体骨髓干细胞动员和综合康复治疗重型颅脑损伤安全有效,可明显改善患者临床神经功能和预后。

Objective To observe the safety and effect of surgery plus autologous bone marrow stem cell mobilization and comprehensive rehabilitation therapy on severe craniocerebral injury patients.Methods A retrospective analysis was done in 75 patients receiving neurosurgical treatment for heavy craniocerebral injury,in which 38 cases received routine neurotrophic and comprehensive rehabilitation therapy（control group）,and 37 cases received autologous bone marrow stem cell mobilization besides the treatment in control group（observation group）.The effect was compared between two groups.Results The National Institutes of Health Stroke Score was significantly lower in observation group（9.83±2.43） than that in control group（17.33±4.16）（t=3.950,P0.01）,and Glasgow Outcome Scale was higher in observation group than that in control group（χ2=10.852,P0.05）.Three weeks after treatment,the rate of CD34＋ CD133＋ in peripheral blood mononuclear cells was（5.92±1.36）% in observation group,obviously higher than that in control group（2.06±0.69）%（P0.05）.No obvious adverse reaction was found in two groups.Conclusion Surgery plus autologous bone marrow stem cell mobilization and comprehensive rehabilitation therapy is safe and effective for severe craniocerebral injury,and can significantly improve the nerve function and prognosis.