艾司氯胺酮在创伤性重型颅脑损伤患者中的应用及其血清神经因子水平变化分析

Application of Esketamine in Patients with Traumatic Severe Brain Injury and Analysis of Changes in Serum Neurofactor Levels

目的:探究艾司氯胺酮在创伤性重型颅脑损伤患者中的应用及其血清神经因子水平变化分析。方法:选取2020年1月至2023年1月本院诊治的创伤性重型颅脑损伤患者180例为研究对象,按随机数表法分两组,均90例。对照组术后给予单一瑞芬太尼药物治疗,而研究组在对照组的基础上给予艾司氯胺酮进行治疗。观察两组不同时点疼痛评分、躁动评分、认知功能(MoCA量表)、血清神经相关细胞因子(BDNF、NGF)及炎症因子(hs-CRP、TNF-α、IL-6)变化情况。结果:给药12h、24h后,两组疼痛评分、躁动评分均较给药前降低,且给药12h、24h后研究组更低。给药后两组MoCA评分均降低,且研究组高于对照组。给药后两组BDNF、NGF均上升,且研究组高于对照组。给药后两组hs-CRP、TNF-α、IL-6均降低,且研究组低于对照组(P<0.05)。结论:在创伤性重型颅脑损伤患者中应用艾司氯胺酮能够有效降低疼痛和躁动评分,提高认知功能,同时促进神经生长因子的生成并降低炎症因子水平。

Objective:To explore the application of ketamine in patients with traumatic severe craniocerebral injury and analyze the changes in serum neurotrophic factor levels.Methods:A total of 180 patients with traumatic severe craniocerebral injury treated in our hospital from January 2020 to January 2023 were selected as the research objects and divided into two groups,with 90 cases in each group,according to the random number table method.The control group received single sufentanil drug treatment after surgery,while the study group received ketamine treatment based on the control group.The pain score,agitation score,cognitive function(MoCA scale),and changes in serum neurotrophic factors(BDNF,NGF)and inflammatory factors(hs-CRP,TNF-α,IL-6)at different time points were observed in both groups.Results:At 12h and 24h after administration,the pain scores and agitation scores in both groups were lower than before administration,and the scores in the study group were lower than those in the control group at 12h and 24h after administration.The MoCA scores in both groups decreased after administration,with the study group higher than the control group.Both BDNF and NGF levels increased after administration in both groups,with the study group higher than the control group.The levels of hs-CRP,TNF-α,and IL-6 decreased in both groups after administration,with the study group lower than the control group(P<0.05).Conclusion:The application of ketamine in patients with traumatic severe craniocerebral injury can effectively reduce pain and agitation scores,improve cognitive function,promote the generation of neurotrophic factors,and reduce the level of inflammatory factors.