醒脑静注射液联合奥拉西坦治疗重型颅脑创伤疗效观察

Therapeutic efficacy of Xingnaojing combined with oxiracetam in treating severe traumatic brain injury

【目的】观察醒脑静联合奥拉西坦治疗重型颅脑创伤的疗效。【方法】108例重型颅脑创伤患者随机分为醒脑静组、奥拉西坦组和联合治疗组,均给予脱水降颅压、止血、营养神经等常规治疗,符合开颅手术指征的行开颅去骨瓣减压术,醒脑静组静脉滴注醒脑静注射液,20 ml/d,奥拉西坦组静脉滴注奥拉西坦注射液,4 g/d,联合治疗组静脉滴注醒脑静注射液,20 ml/d,联合奥拉西坦注射液,4 g/d,14 d为1疗程,治疗2个疗程后观察并对比GCS评分、患者预后及清醒情况。【结果】所有患者治疗2个疗程后,醒脑静组、奥拉西坦组和联合治疗组的GCS评分分别为(7.0±1.2)、(7.2±1.8)和(9.5±1.6)分,预后的良好率分别为22.2%、25.0%和38.9%,重残率分别为19.4%、22.2%和8.3%,植物生存率分别为16.7%、13.9%和5.6%,联合治疗组的这些指标与醒脑静组、奥拉西坦组有显著性差异(P<0.05)。联合治疗组清醒例数(20例)和清醒时间(17.2±5.3)d,醒脑静组和奥拉西坦组清醒例数和清醒时间为12例及(24.6±5.7)d、13例及(23.7±6.5)d,3组有显著性差异(P<0.05)。【结论】醒脑静与奥拉西坦联合治疗,可明显改善重型颅脑创伤患者的预后,提高清醒率并缩短清醒时间,有利于促进病情恢复,提高患者生存质量。

【Objective】To observe the therapeutic efficacy of Xingnaojing combined with oxiracetam in treating severe traumatic brain injury.【Methods】108 patients with severe traumatic brain injury were randomly divided into Xingnaojing group、oxiracetam group and combined treatment group. All patients were conventionally treated with measures for reducing intracranial pressure, hemostasis and neurotrophy. Decompressive craniectomy was performed on the patients who met the craniotomy operation indication. Patients in Xingnaojing group were treated with Xingnaojing injection, 20 ml/d, in oxiracetam group with oxiracetam injection, 4 g/d, and in combined treatment group with Xingnaojing 20 ml/d combined with oxiracetam 4 g/d, 14 d for 1 course. After 2 courses of the treatment, the prognosis and sobriety of the patients were observed and GCS was scored.【Results】After 2 courses of the treatment, in Xingnaojing, oxiracetam and combined treatment groups, the GCS scores were respectively 7.0±1.2, 7.2±1.8 and 9.5±1.6, good prognosis rates were22.2%, 25.0% and 38.9%, severe disability rates were 19.4%, 22.2% and 8.3%, and vegetable survival rates were 16.7%, 13.9% and5.6%. These indexes in combined treatment group were significantly better than those in Xingnaojing group and the oxiracetam group（P〈0.05）. In combined treatment, Xingnaojing and oxiracetam groups, the awake cases were 20, 12 and 13, while awake time was（17.2±5.3） d,（24.6±5.7） d and（23.7±6.5） d. The difference was significant among the three groups（P〈0.05）.【Conclusion】Xingnaojing combined with oxiracetam can significantly improve the prognosis of patients with severe traumatic brain injury, increase sobriety rate,shorten the time of waking up, promote the recovery of illness, and enhance survival quality of the patients.