大黄预防重型颅脑外伤后多器官功能障碍综合征的临床观察

Clinical observation of rhubarb preventing multiple organ dysfunction syndrome after severe brain injury

目的 :探讨预防重型颅脑外伤后多器官功能障碍综合征 (MODS)发生的有效方法。方法 :110例重型闭合性颅脑外伤患者随机分为 2组治疗。42例应用精黄片鼻饲 ,进行早期治疗 (治疗组 ) ,6 8例早期采用常规治疗 (对照组 )。观察 2组伴发多脏器损害的情况 ;同时检测血浆内毒素及肿瘤坏死因子 (TNF)水平的变化。结果 :对照组的 MODS发生率为 5 7.35 % ,病死率为 36 .77% ,治疗组分别降至 35 .72 %和 2 8.5 7% ;治疗组肝、胃肠道、呼吸系统损害明显减少 ,血浆 L PS水平明显下降 (P<0 .0 5 ) ,而 TNF下降更显著 (P<0 .0 1)。结论 :中药大黄对严重颅脑外伤后

Objective:To observe the effective way to preventing the occurrence of multiple organ dysfunction syndrome(MODS) after serious brain injury.Methods:One hundred and ten cases with serious closed brain injury were randomly divided into two groups.Fortytwo patients were treated with wellrhubarb(精黄片) through nose feeding in early periods(treatment group),and 68 patients were treated with conventional therapy(control group).Multiple organ injury were observed,the serum endotoxin and tumor necrosis factor (TNF) were detected in both groups.Results:Compared with control group in 68 cases,the occurrence rate of MODS was reduced from 57 35% to 35 72%,the mortality was dropped from 36 77% to 28 57%,the reduction of damages was obvious especially in hepar,gastrointestine and respiratory system in the treatment group.The level of the serum endotoxin and TNF were reduced obviously ( P <0 05 and P <0 01).Conclusions:Rhubarb has an obviously effect on preventing MODS occurrence after severe brain injury.