高渗盐水联合依达拉奉治疗外伤性脑水肿的疗效及对患者神经功能的影响

Curative efficacy of hypertonic saline in combination with edaravone in the treatment of traumatic cerebral edema and its effects on neurological function

目的探讨高渗盐水联合依达拉奉治疗外伤性脑水肿的疗效及对患者神经功能的影响。方法选取我科收治的90例外伤性脑水肿患者为研究对象,随机分为2组各45例。常规治疗基础上,对照组给予高渗盐水治疗,观察组在对照组基础上联合应用依达拉奉治疗。采用脑卒中神经功能缺损评分(NIHSS)评定神经功能。比较2组治疗后脑水肿体积、神经功能、氧自由基指标水平及不良反应发生情况。结果与对照组相比,观察组治疗后3d、7d和14d时脑水肿体积显著缩小,治疗后7d、14dNIHSS评分显著降低,差异均有统计学意义(P均<0.05)。氧自由基指标方面,与对照组相比,观察组治疗后NO、LPO水平显著降低,SOD水平显著升高,差异均有统计学意义(P<0.05)。治疗过程中,2组均未出现严重不良反应。结论高渗盐水联合依达拉奉治疗外伤性脑水肿疗效可靠,能够显著缩小脑水肿体积,减轻神经功能损害,降低体内氧自由基水平,且不良反应少,临床上值得进一步研究。

Objective To investigate the curative efficacy of hypertonic saline in combination with edaravone in the treatment of traumatic cerebral edema and its effects on neurological function. Methods Ninety cases with traumatic cerebral edema from January 2014 to April 2015 admitted in our department were selected as research objects and were divided into two groups equally. Besides conventional treatments, the control group was given hypertonic saline, while the observation group received hypertonic saline in combination with edaravone. Neurological impairment scale（NIHSS） of stroke was employed to appraise neurological function. Then the volume of cerebral edema, NIHSS scores, indices of oxygen free radical and adverse reactions in two groups were compared. Results 3 days,7 days and 14 days after the treatment, volume of cerebral edema in the observation group was respectively statistically reduced more than that in the control group（all P〈0.05）, and 7 days and 14 days after the treatment, NIHSS scores in the observation group were respectively statistically less than those in the control group（both P〈0.05）. As to indices of oxygen free radical, compared with the control group, the observation group had less levels of both NO and LPO and had higher level of SOD, the differences were statistically significant（all P〈0.05）. During the treatment, there were no severe adverse reactions. Conclusion Therapy of hypertonic saline in combination with edaravone is effective on traumatic cerebral edema, which can significantly reduce volume of cerebral edema, alleviate impairment of neu- rological function and decrease level of oxygen free radical with less adverse reactions.