芳香开窍药经鼻给药对脑损伤昏迷患者脑血流速度及脑血流量的影响

Effect of Aromatic Resuscitation Drug via Nasal Administration on Cerebral Blood Flow Velocity and Cerebral Blood Flow in Comatose Patients with Brain Injury

目的研究芳香开窍药经鼻给药对脑损伤后意识障碍患者脑血流速度及脑血流量的影响,并观察其促苏醒作用。方法 60例脑损伤后意识障碍患者随机分为治疗组、对照组,各30例,两组均给予常规促醒治疗,治疗组在常规治疗的基础上加用芳香开窍药经鼻给药治疗。两组治疗前后均行经颅多普勒脑血管超声检测患者大脑中动脉(MCA)、基底动脉(BA)平均血流速度,对脑损伤区进行CT灌注成像扫描(CTPI)。治疗前后行Glasgow昏迷评分(GCS)进行疗效评定。结果治疗1个月后,治疗组大脑中动脉(MCA)及基底动脉(BA)平均血流速度均快于对照组[(93.65±9.71)cm/s比(81.43±9.52)cm/s),P<0.05;(37.23±5.42)cm/s比(31.52±4.12)cm/s,P<0.05]。治疗后治疗组CTPI参数r CBF、r CBV、r MMF和GCS评分与对照组比较有明显改善[(43.7±13.4)m L/(100g.min)比(35.5±14.8)m L/(100g.min),(3.2±0.6)m L/100g比(2.3±0.7)m L/100g,(4.5±0.9)s比(6.1±0.7)s,(11.23±1.55)分比(8.96±1.41)分,P均<0.05]。结论芳香开窍药经鼻给药能提高脑损伤后昏迷患者的脑血流速度,改善脑损伤区脑血流量,有较好的促醒作用。

Objective To investigate the effect of aromatic resuscitation drug via nasal administrationon cerebral blood flow velocity and cerebralbloodflow in comatose patients with brain injuryand the effect on promoting patients awakening from coma. Methods Sixty unconscious patients with brain injury were randomly assigned to treatment group（n=30） and control group（n=30）. The patients in control group were treated routinely. Besides routine therapy the patients in treatment group were treated with aromatic resuscitation drug through nasal administration. Mean flow rates of middle cerebral artery（MCA） and of basilar artery（BA） were determined by transcranial Doppler ultrasound before and after treatment. CT perfusion imaging（CTPI） wasperformed inbrain injury areas. Glasgow scale（GCS） was used to evaluate the curative effect after treatment. Results After 1-month treatment, the mean flow rates of MCA and of BA intreatment group were faster than that ofcontrol group（93.65 ±9.71cm/s vs 81.43 ±9.52;37.23 ±5.42cm/s; all P 〈0.05）. Test results showed improvement in CTPI in treatment group compared with control group（r CBF：43.7 ±13.4m L/（100g·min） vs 35.5 ±14.8m L/（100g·min）; r CBV： 3.2 ±0.6m L/100 g vs 2.3 ±0.7m L/100g;r MTT： 4.5±0.9s vs 6.1±0.7s; all P 〈0.05）. After treatmentthe GCS score in treatment group was higher than that of control group（11.23±1.55 vs 8.96±1.41, P 〈0.05）. Conclusion Aromatic resuscitation drug via nasal administration can improve the cerebral blood flow velocity and cerebralbloodflow in comatose patients with brain injury, and it can promote those patients awakening from coma.