胞磷胆碱钠联合高压氧治疗放射性脑病的临床研究

Treatment for radiation encephalopathy by citicoline sodium combined with hyperbaric oxygen

目的观察胞磷胆碱钠联合高压氧治疗放射性脑病的临床疗效。方法回顾性分析87例因头颈部放射性治疗所致的放射性脑病患者,分为治疗组(n=45)与对照组(n=42)。治疗组疗法为胞磷胆碱钠(0.2 g,每日3次)联合高压氧;对照组单纯应用高压氧治疗。两组患者均常规采用地塞米松、甘露醇等药物支持对症治疗;共行3个疗程。疗效判断依据患者症状改善情况、生活自理情况以及CT或MRI复查病灶改变情况。结果治疗组治愈10例,显效18例,有效11例,有效率为86.7%。对照组治愈8例,显效12例,有效9例,有效率为69.0%,两组有效率比较差异有统计学意义(P<0.05)。结论胞磷胆碱钠联合高压氧治疗放射性脑病可有效增加高压氧治疗放射性脑病的疗效。

Objective To assess the clinical efficacy of citicoline sodium combined with hyperbaric oxygen in the treatment of radiation encephalopathy. Methods Eighty-seven patients with radiation encephalopathy caused by head and neck radiation therapy were divided into study group （ n = 45 ） and control group （ n = 42）. Patients in study group received citicoline sodium （0.2 g, tid po） and hyperbaric oxygen treatment; patients in control group received hyperbaric oxygen therapy alone. Dexamethasone, mannitol and other supporting drugs were administrated routinely, and a total of three treatment courses were given for both groups. CT or MRI scans were performed; the symptoms and performance status of patients were evaluated before and after treatment in two groups. Results There were 10 cases of cure, 18 cases of marked effect and 11 cases of effect with an overall effective rate of 86.7% in study group. There were 8 cases of cure, 12 cases of marked effect and 9 cases of effect with an overall effective rate of 69.0% in control group. There was significant difference in overall effective rate between two groups （ P 〈 0.05 ）. Conclusion Citicoline sodium combined with hyperbaric oxygen can improve therapeutic efficacy for patients with radiation encephalopathy.