亚低温状态下大剂量硫酸镁治疗弥漫性轴索损伤的临床研究  

Clinical study on large-dose of magnesium sulfate in treatment of diffuse axonal injury under subhypothemia.

作　　者：赵灵[1] 林小华[2] 李永波[1] 楚磊[1] 侯玉宇[1] 欧兴义[1] 

机构地区：[1]暨南大学医学院第三附属医院外科ICU,广东省珠海市519000 [2]中山市人民医院脑外科

出　　处：《中国综合临床》2006年第1期63-65,共3页Clinical Medicine of China

摘　　要：目的观察联合使用亚低温及大剂量硫酸镁治疗弥漫性轴索损伤的临床效果。方法52例弥漫性轴索损伤患者,随机分为治疗组和对照组各26例。治疗组患者入院20min后给予2g(16mmol)硫酸镁静脉注射和7.8g(65mmol)硫酸镁持续24h静脉滴注,自伤后6h开始联合亚低温治疗,使直肠温度控制在33～35℃,治疗时间为3～5d。对照组按普通常规治疗。两组患者均连续监测血清神经元特异性烯醇酶(NSE)1周,格拉斯哥昏迷评分及预后分级于治疗后1d、3d、1周和3个月进行评估及统计。结果治疗不同时间两组血清NSE和格拉斯哥昏评分比较差异均有显著性(P<0.01或0.05)。结论联合使用亚低温和大剂量硫酸镁治疗弥漫性轴索损伤疗效显著。Objective To observe the clinical effect of combined subhypothemia and large-dose of magnesium sulfate in the treatment of diffuse axonal injury. Methods 52 cases of diffuse axonal injury were randomly divided into treatment group and control group （ n = 26 for each ）. The treatment group was intravenously injected with 2g （ 16mmol ） magnesium sulfate 20 min after admission and got continuous intravenous drip of 7.8g （ 65 mmol ） for 24 h. The patients were treated 6 h after injury with combined subhypothemia which put rectal temperature under 33-35 ℃ ,for 3-5 d. The control group was treated routinely. Neuron specific enolase （NSE） was measured continuously in the two groups for 1 week. Glasgow Coma Scale （ GCS） and prognosis scoring were evaluated at ld,3d,1 week and 3 months after treatment. Results Serum NSE and GCS were significantly different between treatment group and controls （P 〈 0.01 or P 〈 0.05 ）. Conclusion Combined subhypothemia and magnesium sulfate presents significant therapeutic effect in the treatment of diffuse axonal injury.

关 键 词：弥漫性轴索损伤 硫酸镁 神经元特异性烯醇酶 亚低温治疗 

分 类 号：R651.1[医药卫生—外科学]