纳洛酮血肿腔内注射对中重度颅脑损伤患者血浆β-内啡肽的影响  

Effects of naloxone injection into hematoma cavity on plasma β-endorphin in patients with moderate and severe brain injury

作　　者：黄源[1] 陈刚[1] 王远华[1] 康睿[1] 罗治彬[2] 

机构地区：[1]重庆市合川区人民医院神经外科,401520 [2]重庆市合川区人民医院肿瘤科,401520

出　　处：《检验医学与临床》2013年第19期2508-2509,2512,共3页Laboratory Medicine and Clinic

基　　金：重庆市卫生局科技计划项目(2011-2-431)

摘　　要：目的探讨血肿腔内注入盐酸纳洛酮治疗中重度颅脑损伤的疗效及安全性。方法 86例中重度颅脑损伤患者随机分成对照组(n=26)、静脉滴注纳洛酮组(n=30)和血肿腔内灌注纳洛酮组(n=30),观察各组生命体征、意识复苏时间、血浆β-内啡肽(β-EP)的变化,3个月后进行格拉斯哥预后评分(GOS)。结果纳洛酮治疗组患者的血液及呼吸循环恢复稳定较快。腔内注入纳洛酮组的意识复苏时间比对照组和静脉滴注纳洛酮组明显缩短(P<0.01)。治疗后第10天,纳洛酮治疗组比对照组的GCS上升,且血肿腔内灌注组较静脉滴注纳洛酮组升高明显(P<0.05)。而血肿腔灌注纳洛酮组β-EP含量显著低于静脉滴注组及对照组(P<0.05)。随访3个月后静脉滴注组患者GOS比对照组升高,而且血肿腔内灌注组较静脉滴注纳洛酮组升高明显(P<0.05)。结论血肿腔内灌注纳洛酮可能通过拮抗β-EP的作用,缩短中重度颅脑损伤昏迷时间,促进患者神经功能恢复,改善预后。Objective To study the curative effects and safety of naloxone injection into the hematoma cavity in patients with moderate and severe brain injury.Methods Eighty-six patients with moderate and severe brain injury patients were randomly divided into routine treatment group（n=26）,naloxone injection by intravenous infusion group（n=30）and naloxone injection into hematoma cavity group（n=30）.Vital signs,consciousness recovery time and levels of plasmaβ-endorphin（β-EP）were observed and GOS score was evaluated after 3months.Results The recovery time of blood circulation and respiration was shorter in naloxone group than routine treatment group.Consciousness recovery time in of hematoma cavity group was shorter than control group and intravenous infusion group（P0.01）.Ten days after therapy,GCS of patients in naloxone treated group was higher than control group,and the increasing of GCS in hematoma cavity group was more remarkable than intravenous infusion group（P0.05）.Plasmaβ-EP level in hematoma cavity group was lower than intravenous infusion group,and that in control group was lowest（P0.05）.Three months after therapy,GOS in intravenous infusion group was higher than control group,and the increasing of GOS in hematoma cavity group was more remarkable than intravenous infusion group（P 0.05）.Conclusion Naloxone injection into hematoma cavity could decreasesβ-EP levels and coma time,enhance the recovering of neurological function and improve curative effect.

关 键 词：纳洛酮 颅脑损伤 Β-内啡肽 

分 类 号：R743.34[医药卫生—神经病学与精神病学]