醒脑静注射液辅助手术治疗急性重型颅脑损伤的疗效观察

Therapeutic efficacy of Xingnaojing injection as an adjuvant treatment in operation for acute severe traumatic brain injury

目的观察醒脑静注射液辅助手术治疗急性重型颅脑损伤(STBI)的临床疗效。方法本院神经外科收治的急性STBI患者60例,按数字奇偶法将其分为观察组与对照组(各30例),2组患者入院后均给予紧急对症处理及术后常规治疗,对照组行标准大骨瓣减压术,观察组在对照组基础上加用醒脑静注射液辅助治疗,治疗后评估2组临床疗效,检测患者血清炎症因子水平变化,并记录并发症发生情况。结果治疗前,2组中医证候积分比较差异无统计学意义(P>0.05);治疗后,2组中医证候积分较治疗前显著下降,观察组中医证候积分显著低于对照组(P<0.05);观察组治疗总有效率(90%)显著高于对照组(73%)(P<0.05);治疗前,2组血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-2、IL-6水平比较差异无统计学意义(P>0.05);治疗后,2组血清TNF-α、IL-2、IL-6水平较治疗前显著下降,观察组血清TNF-α、IL-2、IL-6水平显著低于对照组(P<0.05);观察组治疗期间出现脑积水、脑缺氧、脑水肿、颅内感染等并发症发生率(7%)显著低于对照组(30%)(P<0.05)。结论醒脑静注射液辅助标准大骨瓣减压术治疗急性STBI,有利于提高临床治疗效果,有效减轻患者症状,并能抑制炎性反应,降低并发症发生率。

Objective To investigate the clinical efficacy of Xingnaojing injection in the treatment of acute severe traumatic brain injury(STBI).Methods The patients were divided into study group and control group(n=30 each)according to the numerical parity method.After admission,the two groups of patients were given emergent symptomatic treatment and routine postoperative care.The control group underwent standard large bone flap decompression,while in the study group,Xingnaojing injection was givenin addition to the treatment given tothe control group.After treatment,the two groups were evaluated for clinical efficacy,examined for changes inthe serum inflammatory factors,and recorded for the occurrence of complications.Results At baseline,there was no significant difference in TCM syndrome scores between the two groups(P>0.05).After treatment,the TCM syndrome scores in the two groups were significantly lowered compared with baseline,and the reduction was even greater in the study group than in the control group(P<0.05).The total effectiveness rate in the study group(90%)was significantly higher than that in the control group(73%)(P<0.05).At baseline,there was no significant differences in serum TNF-α,IL-2 and IL-6 levels between the two groups(P>0.05).After treatment,the levels of serum TNF-α,IL-2 and IL-6 in the two groups were significantly lowered compared with baseline,and the reductions in levels of serum TNF-α,IL-2 and IL-6 in the study group were significantly greater compared with the control group(P<0.05).During the treatment,the incidence of complications such as hydrocephalus,cerebral hypoxia,cerebral edema,and intracranial infection was significantly lower in the study group(7%)than that in the control group(30%)(P<0.05).Conclusion Xingnaojing injection as an adjuvant treatment in standard large bone flap for treatment of acute STBI can be beneficial to improve the clinical efficacy,alleviate the symptoms,inhibit inflammatory reactions,and reduce the incidence of complications.