高流量给氧和纳洛酮对重型颅脑损伤疗效分析  

作　　者：周忠义[1] 罗满辉[1] 刘洁[1] 陈甘海[1] 刘耀[1] 李平雨[1] 

机构地区：[1]广东医学院附属厚街医院神经外科,523945

出　　处：《当代医学》2009年第25期3-4,共2页Contemporary Medicine

摘　　要：目的探讨高流量给氧和盐酸纳洛酮对急性重型颅脑损伤的临床疗效。方法120例急性重型颅脑损伤患者随机分成对照组40例,高流量给氧组40例,纳洛酮治疗组40例;观察三组颅内压、脑水肿、髓鞘碱性蛋白、伤后6个月GOS评分变化。结果纳洛酮治疗组颅内压增高幅度和脑水肿程度较高流量给氧、对照组明显减轻;纳洛酮治疗组脑脊液髓鞘碱性蛋白水平较对照组明显下降;纳洛酮治疗组6个月后死亡率、语言及肢体功能障碍率显著低于对照组和高流量给氧组。结论纳洛酮可降低急性重型颅脑损伤患者ICP增高的幅度、减轻脑水肿、降低死亡率和致残率、促进患者神经功能恢复、改善预后,而高流量给氧治疗与对照组无显著性差异。Objective To investigate the clinical effect of high-flow oxygen therapy and naloxone hydrochloride in treatment of acute severe traumatic brain injury. Methods 120 patients with severe traumatic brain injury（GCS 3- 8）were randomly divided into three groups, control group （40 patients）, high-flow oxygen therapy group （40 patients） and naloxone hydrochloride treatment group （40 patients）. The ICP, the extent of brain edema, myelin basic protein, GOS （6 month after injury） of the three groups were compared. Results The ICP and extent of brain edema and myelin basic protein of the naloxone hydrochloride treatment group were significantly lower than that of the control group and high-flow oxygen therapy group. After 6 month, the mortality and the rate of language and limbs disturbance in the naloxone hydrochloride treatment group was lower than that of high-flow oxygen therapy group and control group. Conclusion Naloxone hydrochloride can cut down ICP, relieve brain edema as well as reduce the mortality and the disability in patients with acute severe traumatic brain injury. But there was no significant difference between the high-flow oxygen therapy group and control group.

关 键 词：重型颅脑损伤 高流量给氧治疗 纳洛酮 

分 类 号：R651.15[医药卫生—外科学] R472.9[医药卫生—临床医学]