联合用药对急性脑卒中伴意识障碍患者脑功能的保护作用

Protective effect of combined medication on brain function in acute stroke patients with conscious disturbance

目的探讨纳洛酮联合醒脑静注射液对急性脑卒中伴意识障碍患者脑功能的保护作用。方法 120例急性脑卒中伴意识障碍患者,随机分为2组各60例,入院后均给予吸氧、降低颅内压、纠正酸碱和电解质平衡、营养神经等常规治疗,对照组在此基础上予以2.4mg纳洛酮配入250mL生理盐水静滴,1次/d,连续14d;观察组在对照组的基础上加用30mL醒脑静注射液配入250mL生理盐水静滴,1次/d,连续14d。对入选患者治疗前、治疗后2周、治疗3个月进行格拉斯哥昏迷(GCS)评分和美国脑卒中量表(NIHSS)评分;记录患者意识觉醒时间;测量2组患者治疗前、治疗后2周血清神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)水平和颅内压值。结果与治疗前比较,2组患者GCS评分均降低,NIHSS评分均增高,血清NSE、hs-CRP水平、颅内压值均下降;与对照组比较,观察组治疗后GCS评分明显升高,NIHSS评分明显降低,血清NSE、hsCRP水平、颅内压值明显降低,意识觉醒时间短于对照组,差异具有统计学意义(P<0.05)。结论纳洛酮联合醒脑静注射液可保护急性脑卒中伴意识障碍患者脑功能,明显改善患者意识状态。

Objective To investigate the protective effect of naloxone combined with Xingnaojing injection on brain function in acute stroke patients with conscious disturbance .Methods 120 cases with conscious disturbance in our hospital were selected and divided into two groups ,60 cases in each group .They were all received oxygen inhalation ,intracranial pressure reduction ,cor-rection of electrolyte and acid-base balance ,neuro-nutrition treatment .Control group was treated with 2.4 mg naloxone and 250 mL saline drip on this basis ,1 time/d ,for 14 d;observation group was treated with 30 mL Xingnaojing injection and 250 mL saline drip on basis of control group ,1 time/d ,for 14 d .Patients were assessed with GCS ,NIHSS before treatment ,2 weeks ,3 months af-ter treatment ;consciousness raising time of the patients were recorded ;NSE ,hs-CRP level and intracranial pressure of the two groups before treatment ,2 weeks after treatment were measured .Results Compared with before treatment ,GCS of patients in the two groups were all declined ,NIHSS were increased ,and NSE ,hs-CRP level ,intracranial pressure were declined ;compared with control group ,GCS of patients in the observation group were significantly increased ,NIHSS scores were obviously declined ,and NSE ,hs-CRP level ,intracranial pressure were significantly declined ,consciousness raising time was shorter than control group ,the difference was statistical significant （P〈0.05） .Conclusion Naloxone combined with Xingnaojing injection can protect brain func-tion in acute stroke patients with conscious disturbance ,it can obviously improve conscious state of patients .