注射用甲泼尼龙琥珀酸钠治疗外伤性脑水肿的疗效与安全性  

Efficacy and safety of methylprednisolone in the treatment of traumatic brain edema

作　　者：赵彬[1,2] 姚鑫[3] 

机构地区：[1]天津医科大学,天津300070 [2]静海县医院神经外科,天津静海301600 [3]天津市环湖医院神经外科,天津300060

出　　处：《中国临床药理学杂志》2015年第17期1716-1717,1735,共3页The Chinese Journal of Clinical Pharmacology

基　　金：天津市卫生局科技基金资助项目(2011kz07)

摘　　要：目的探讨注射用甲泼尼龙琥珀酸钠治疗颅脑外伤性脑水肿临床疗效及安全性。方法选取颅脑外伤患者49例,随机分为试验组23例和对照组26例。试验组,静脉滴注甲泼尼龙琥珀酸钠40 mg+0.9%生理盐水100 m L,每日2次;对照组,静脉推注地塞米松20 mg,每日2次,2组患者疗程均为7天。分析比较2组患者术后14天内脑水肿情况及术后6个月神经功能恢复情况。结果术后随访6个月,试验组恢复良好8例,死亡3例,对照组恢复良好6例,死亡4例;2组患者临床疗效比较差异无统计学意义(P>0.05);术后第3天和第7天,试验组脑水肿程度显著低于对照组(P<0.05),术后14天,2组脑水肿程度差异无统计学意义(P>0.05);用药期间,2组各发生应激性溃疡出血1例。结论注射用甲泼尼龙琥珀酸钠较地塞米松可更为快速的缓解外伤性脑水肿。Objective To evaluate the efficacy and safetys of methylprednisolone in the treatment of traumatic brain edema. Methods Forty nine patients with traumatic brain edema were included in this study. Of the included 49 cases,23 patients（ experiment group） received methylprednisolone 40 mg ＋ 0. 9% normal saline 100 m L intravenous drip bid;26 cases（ control group） treated with dexamethasone 20 mg intravenous bid. The schedule were 7 days for the two groups. The brain edema were compared between the two groups within two weeks. The prognosis were evaluated after 6 months. Results In the next 6 months follow up,8 patients recovery well and 3 cases dead in the experiment. For control group,6 patients recovery well and 4 patients dead. The clinical efficacy were not statistical different between the experiment and control groups（ P〉 0. 05）. The brain edema in the control group were significant severe than experiment group（ P 〈0. 05）. There was 1 case of stress ulcer in the experiment and control group. Conclusion Methylprednisolone can significant reduce the brain edema in patients with brain trauma.

关 键 词：注射用甲泼尼龙琥珀酸钠 地塞米松 脑水肿 预后 

分 类 号：R977.11[医药卫生—药品] R651.1[医药卫生—药学]