地塞米松与甲泼尼龙琥珀酸钠联合治疗对外伤性脑水肿开颅术后神经功能及NSE NO NE的影响

Effects of Dexamethasone Combined with Methylprednisolone Sodium Succinate on Neurological Function NSE NO and NE after Craniotomy for Traumatic Brain Edema

目的:研究地塞米松联合甲泼尼龙琥珀酸钠对外伤性脑水肿开颅术后神经功能及NSE、NO、NE的影响。方法:选取2016年8月至2017年7月我院收治的50例外伤性脑水肿患者,采用简单随机分组法分为观察组和对照组,25例每组。对照组在开颅手术后使用地塞米松,观察组联合甲泼尼龙琥珀酸钠。比较两组临床疗效,脑水肿体积和神经功能,NSE、NO、NE水平。结果:治疗后,观察组临床总有效率显著高于对照组(P<0.05)。治疗前,两组患者脑水肿体积、NIHSS评分比较无显著差异(P>0.05),治疗后3d、7d、14d两组患者脑水肿体积、NIHSS评分呈下降趋势,其中观察组在治疗后3d、7d、14d的脑水肿体积、NIHSS评分显著低于对照组(P <0.05),两组在组间、不同时间点、组间·不同时间点方面比较存在显著差异(P<0.05)。治疗前,两组患者NSE、NO、ET水平比较无显著差异(P>0.05),治疗后3d、7d两组患者NSE水平呈上升趋势,在治疗后14d,两组患者NSE水平呈下降趋势,治疗后3d、7d、14d两组患者NO、ET水平呈下降趋势,其中观察组在治疗后3d、7d、14d显著低于对照组(P <0.05),两组在组间、不同时间点、组间·不同时间点方面比较存在显著差异(P<0.05)。结论:外伤性脑水肿患者在开颅手术后经地塞米松联合甲泼尼龙琥珀酸钠治疗,能有效改善患者脑水肿和神经功能,能有效降低NSE、NO、NE水平,临床疗效良好。

Objective: To study the effects of dexamethasone combined with methylprednisolone sodium succinate on neurological function, NSE, NO and NE after craniotomy for traumatic brain edema. Methods: Fifty patients with traumatic brain edema admitted to our hospital from August 2016 to July 2017 were randomly divided into observation group and control group with 25 cases in each group. The control group was treated with dexamethasone after craniotomy, while the observation group was treated with methylprednisolone sodium succinate. The clinical efficacy, brain edema volume and neurological function, levels of NSE, NO and NE were compared between the two groups. Results: After treatment, the total clinical effective rate of the observation group was significantly higher than that of the control group (P<0.05). Before treatment, there was no significant difference in the volume of brain edema and NIHSS score between the two groups (P>0.05). The volume of brain edema and NIHSS score of the two groups showed a downward trend on the 3rd, 7th and 14th day after treatment. The volume and NIHSS score of the observation group were significantly lower than those of the control group on the 3rd, 7th and 14th day after treatment (P<0.05). The two groups were compared in the aspects of group, time point and time point. There were significant differences (P<0.05). Before treatment, there was no significant difference in NSE, NO and ET levels between the two groups (P>0.05). After treatment, the NSE levels of the two groups showed an upward trend on the 3rd and 7th day. After treatment, the NSE levels of the two groups showed a downward trend on the 14th day. After treatment, the levels of NO and ET of the two groups showed a downward trend. The observation group was significantly lower than the control group on the 3rd, 7th and 14th day (P<0.05). There were significant differences in different time points, between groups and at different time points (P<0.05). Conclusion: Traumatic brain edema patients treated with dexamethasone combined with methylprednisolone sodium succinate after craniotomy can effectively improve brain edema and neurological function, effectively reduce the levels of NSE, NO and NE, and have good clinical efficacy.