黄芪注射液联合亚冬眠治疗在重型颅脑损伤患者抢救中的临床意义探讨

Investigation on clinical significance of using Astragalus injection combined with sub-hibernation to patients with severe craniocerebral injury

目的 观察黄芪注射液联合亚冬眠治疗对重症颅脑损伤患者的临床疗效.方法 采用回顾性调查研究方法,选择2010年1月至2016年12月甘肃省白银市第一人民医院重症医学科住院的重型颅脑损伤患者89例,采用黄芪注射液联合亚冬眠治疗的45例患者为观察组,采用常规治疗的44例患者为对照组.比较两组治疗前后格拉斯哥昏迷评分（GCS评分）、昏迷时间、致残率、病死率及肺部感染、尿道感染发生率的差异.结果 两组治疗后GCS评分均较治疗前明显升高,且以治疗后30 d观察组的升高程度较对照组更显著（分：13.15±2.53比8.79±1.59,P〈0.05）.观察组昏迷时间较对照组明显缩短（d：5.79±1.89比13.65±2.73）,致残率〔13.33%（6/45）比22.73%（10/44）〕、病死率〔17.78（8/45）比31.82%（14/44）〕均较对照组明显降低（均P〈0.05）,肺部感染〔24.44%（11/45）比31.82%（14/44）〕、尿道感染〔28.89%（13/45）比36.36%（16/44）〕 发生率均较对照组有所降低,但两组比较差异无统计学意义（均P〉0.05）.结论 黄芪注射液联合亚冬眠治疗可以使重型颅脑损伤患者昏迷程度明显改善,昏迷时间缩短,病死率、致残率降低.

Objective To observe the clinical therapeutic effect of Astragalus injection combined with sub-hibernation therapy for treatment of patients with severe craniocerebral injury.Methods A retrospective research method was conducted, and 89 cases with severe craniocerebral injury admitted to the Department of Critical Care Medicine of the First People Hospital of Baiyin in Gansu Province from January 2010 to December 2016 were enrolled. Astragalus injection combined with sub-hibernation was applied for treatment of 45 patients in the observation group, and for another 44 cases assigned in the control group, simply conventional treatment was used. The Glasgow coma score （GCS）, coma time, ratio of cripple, mortality, incidences of pulmonary infection and urinary tract infection were compared between the two groups.Results After treatment, GCS scores were significantly higher than those before treatment in both groups, but the degree of increase was more marked on the 30 days after treatment in the observation group than that in the control group （13.15±2.53 vs. 8.79±1.59,P 〈 0.05）. Compared with the control group, coma time was obviously shorter （days： 5.79±1.89 vs. 13.65±2.73）, ratio of cripple [13.33% （6/45） vs. 22.73% （10/44）] and mortality [17.78% （8/45） vs.31.82% （14/44）] were significantly lower in observation group （allP 〈 0.05）; the incidences of pulmonary infection [22.44% （11/45） vs. 31.82% （14/44）] and urinary tract infection [28.89% （13/45） vs. 36.36% （16/44）] were lower in the observation group, but the differences between the two groups were not statistically significant （bothP 〉 0.05）.Conclusions The treatment of Astragalus injection combined with sub-hibernation treatment can significantly improve the coma degree, shorten the time of coma, reduce the mortality and disability rate of patients with severe craniocerebral injury.