重组人促红细胞生成素联合预见性双侧去骨瓣减压术对重型颅脑损伤的疗效

Effects of Recombinant Human Erythropoietin Combined with Predictive Bilateral Decompressive Craniectomy in Patients with Severe Craniocerebral Injury

目的:探讨重组人促红细胞生成素联合预见性双侧去骨瓣减压术治疗重型颅脑损伤的疗效。方法:重型颅脑损伤患者98例随机分为观察组和对照组,各49例。在基础治疗的基础上,对照组采取预见性双侧去骨瓣减压术治疗,观察组采取重组人促红细胞生成素联合预见性双侧去骨瓣减压术治疗。比较治疗前、后,2组血清S-100β蛋白、NSE水平,美国国立卫生研究院卒中量表(NIHSS)评分,格拉斯哥昏迷量表(GCS)评分及随访6个月后的格拉斯哥预后量表(GOS)评分。结果:治疗后2组NIHSS评分均较治疗前降低,且观察组较对照组低,GCS评分均较治疗前提高,且观察组较对照组高(均P<0.05);2组血清S-100β蛋白、NSE水平均较治疗前降低,且观察组较对照组低(均P<0.05);治疗后随访6个月,观察组GOS评分为5分和4分的患者多于对照组(P<0.05)。结论:采用重组人促红细胞生成素联合预见性双侧去骨瓣减压术治疗重型颅脑损伤患者能显著降低患者神经功能损伤及昏迷程度,改善患者预后。

Objective: To investigate the therapeutic effect of recombinant human erythropoietin combined with predictive bilateral decompressive craniectomy in patients with severe craniocerebral injury. Methods: In this study, 98 patients with severe craniocerebral injury were randomly divided into the observation group and control group with 49 patients per group. On top of basic treatment, the control group was treated with predictive bilateral decompressive craniectomy and the observation group with recombinant human erythropoietin combined with predictive bilateral decompressive craniectomy. The expression level of related indexes of serum nerve injury [S-100β protein and neuron specific enolase (NSE)] and degree of neurological impairment (NIHSS score) and coma (GCS score) before and after treatment were compared between the two groups. After 6 months, the prognosis (GOS) of the two groups was compared. Results: NIHSS scores of the two groups after treatment were lower than those before treatment, and scores of the observation group were lower than those of the control group. After treatment, GCS scores of both groups were higher than those before treatment with the observation group showing higher scores than the control group (P<0.05). After treatment, the serum levels of S-100 β protein and NSE of the two groups were lower than those before treatment, and levels in the observation group were lower than those in the control group (all P<0.05). Six months after treatment, the number of patients in the observation group with a GOS of 5 or 4 was greater than that in the control group (P<0.05). Conclusion: Recombinant human erythropoietin combined with predictive bilateral decompressive craniectomy in the treatment of patients with severe craniocerebral injury can significantly reduce the degree of neurological impairment and coma in patients and improve their prognosis.