杜秘克辅助治疗神经外科昏迷的价值及可行性研究  

Study on the application value and feasibility of duphalac adjunctive therapy on neurosurgical coma

作　　者：张玲[1] 孙林[1] ZHANG Lingy SUN Lin(Department of Neurosurgery, Central Hospital of Xiangyang City, Hubei, Xiangyang 441021, China)

机构地区：[1]湖北省襄阳市中心医院湖北文理学院附属医院神经外科,441021

出　　处：《河北医药》2017年第10期1477-1480,共4页Hebei Medical Journal

摘　　要：目的研究分析杜秘克辅助治疗神经外科昏迷的价值及可行性。方法选取2014年5月至2016年5月进行治疗的神经外科昏迷患者102例为研究对象,随机将所有患者分为对照组和研究组。对照组患者给予常规的治疗和护理,研究组患者在对照组患者治疗的基础上鼻管饲杜秘克辅助治疗,采用GCS评分标准对2组患者治疗后10 d、20 d和30 d清醒状况进行统计,检测患者血液中血氨浓度及血清中内毒素的含量。并对患者血清中肿瘤坏死因子-α(TNF-α)、血清免疫球蛋白(IgA,IgG,IgM)的水平、外周血T淋巴细胞群(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+)水平进行检测,对患者治疗期间并发症情况进行记录和统计。结果研究组患者10 d、20 d、30 d清醒、无效情况及治疗后10 d改善情况与对照组相比较差异有统计学意义(P<0.05)。研究组患者10 d、20 d、30 d血氨水平、20 d、30 d内毒素水平与治疗前及对照组相比较差异有统计学意义(P<0.05)。研究组患者治疗后10 d、20 d、30 d的TNF-α水平、20 d、30 d的IgA及IgM水平与治疗前相比较差异有统计学意义(P<0.05)。研究组患者治疗后10 d、20 d、30 d的TNF-α及IgM水平、20 d、30 d的IgA水平与对照组相比较差异有统计学意义(P<0.05),研究组患者治疗后20 d、30 d的CD_3^+比例、CD_4^+/CD_8^+及治疗后30 d CD_4^+比例与对照组相比较差异均有统计学意义(P<0.05)。研究组患者肺部感染、尿路感染及便秘情况与对照组相比较差异均有统计学意义(P<0.05)。结论杜秘克对神经外科昏迷患者具有良好的辅助治疗作用。Objective To investigate the application value and feasibility of duphalac adjunctive treatment on neurosurgery coma. Methods One hundred and two patients with neurosurgical coma who were treated in our hospital from May 2014 to May 2016 were randomly divided into control group and observation group. The patients in control group were treated by conventional treatment and care,however,the patients in observation group,on the basis of control group,were treated by nasal tube feeding with duphalac. The patient＇s conscious status on 10 d,20d,30 d after treatment was evaluated according to GCS scoring criteria,and the blood ammonia concentration,serum levels of endotoxin,tumor necrosis factor-α（ TNF-α）,the levels of immunoglobulin（ IgA,IgG,IgM） in peripheral blood,T lymphocytes（ CD3^＋,CD4^＋,CD8^＋,CD4^＋/CD8^＋） were detected and compared between two groups. Moreocer the incidence rate of complications during treatment were observed and statistically analyzed. Results There were significant differences in the conscious status on 10 d,20d,30 d after treatment,inefficiency condition and improvement status of clinical symptoms on 10 days after treatment between two groups（ P〈0. 05）. There were significant differences in blood ammonia levels on 10 d,20d,30 d and levels of endotoxin on 20 d,30d in observation group before treatment and after treatment,and between observation group and control group（ P〈0. 05）. There were significant differences in serum levels of TNF-α on 10 d,20d,30 d and serum levels of IgA and IgM on 20 d,30d after treatment in observation group,as compared with those before treatment（ P〈0. 05）. Moreover there were significant differences in the serum levels of TNF-α and IgM on 10 d,20d,30 d after treatment and serum levels of IgA on 20 d,30d after treatment between observation group and control group（ P〈0. 05）. Moreover there were significant differences in CD3~＋proportion and ratio of CD4~＋/CD8~＋on 20 d,30d after treatment as well as CD4^＋propor

关 键 词：杜秘克 神经外科昏迷 辅助治疗 

分 类 号：R256.24[医药卫生—中医内科学]