亚低温联合复方脑肽节苷脂注射液治疗重症颅脑损伤的临床疗效及生活质量研究  

Clinical efficacy and quality-of-life scale of mild hypothermia combined with compound porcine cerebroside and ganglioside injection in the treatment of severe craniocerebral injury

作　　者：黄伟毅[1] 关良劲 Huang Weiyi;Guan Liangjing(Department of Rehabilitation, the General Hospita of Guangzhou Military Region, Guangzhou 510010,China)

机构地区：[1]广州军区总医院康复科,广州510010 [2]广州市天河中医院ICU

出　　处：《脑与神经疾病杂志》2018年第2期100-104,共5页Journal of Brain and Nervous Diseases

摘　　要：目的对亚低温联合复方脑肽节苷脂注射液治疗重症颅脑损伤患者的临床疗效进行观察,并对生活质量进行评价。方法将本院收治的85例重症颅脑损伤患者按随机数字表法分为对照组(n=42)和观察组(n=43),对照组患者采用一般常规治疗,观察组患者在对照组基础上采用亚低温联合复方脑肽节苷脂注射液进行治疗。比较两组患者治疗前后的静息能量消耗(REE)、颅内压(ICP)水平、格拉斯哥昏迷量表(GCS)评分和神经功能缺损程度分级(NIHSS)评分及血浆神经肽Y(NPY)、降钙素基因相关肽(CGRP)、血清星形胶质源性蛋白(S100β)、神经元特异性烯醇酶(NSE)及血清胶质纤维酸性蛋白(GFAP)水平,并采用简易精神状态评价量表(MMSE)和蒙特利尔认知评估量表(Mo CA)评价并比较两组患者治疗前后的认知功能障碍改善情况。采用格拉斯哥预后(GOS)评分、远期生活质量评估量表(KPS)评分及Barthel指数评定量表评分评价并比较两组患者的预后和日常生活质量。采用随访3个月的GOS评分评价并比较两组患者的临床疗效,同时记录两组患者治疗期间的不良反应发生情况。结果观察组患者治疗后的REE、ICP水平、GCS评分、NIHSS评分及NPY、CGRP、S100β、NSE和GFAP水平的改善情况均显著优于对照组(P<0.05);观察组治疗后的认知功能MMSE和Mo CA评分均显著高于对照组(P<0.05);观察组治疗后的GOS评分、KPS评分和Barthel指数评分均显著高于对照组(P<0.05);观察组的临床疗效总有效率显著高于对照组(81.40%vs 61.90%,P<0.05);两组患者在治疗期间的不良反应发生率无显著差异(P>0.05)。结论亚低温联合复方脑肽节苷脂注射液治疗重症颅脑损伤能够提高临床疗效,降低患者的能量代谢和颅内压,改善神经功能和认知状态,提高患者的生活质量,且安全性良好。Objective To study the clinical efficacy and quality-of-life scale of mild hypothermia combined with compound porcine cerebroside and ganglioside injection in the treatment of severe craniocerebral injury. Method 85 cases of severe craniocerebral injury were randomly divided into the control group （ n=42 ） and the observation group （ n=43 ） . The patients in the control group received general conventional treatment, and the obervation group were treated with mild hypothermia combined with compound porcine cerebroside and ganglioside injection on the basis of the control group. The resting energy expenditure （ REE ） , intracranial pressure （ ICP ） , Glasgow Coma Scale （ GCS ） score, NIHSS score and the levels of NPY, CGRP, S100β, NSE, GFAP were compared before and after treatment in two groups. MMSE scores and MoCA scores were used to evaluate and compare the improvement of cognitive function before and after treatment in two groups. The GOS scores, KPS scores and Barthel index scores were used to evaluate and compare the prognosis and quality of daily life in two groups. GOS score was used to evaluate the clinical efficacy of two groups. The adverse reactions during the treatment period were recorded in two groups. Results The improvement of REE, ICP level, GCS scores, NIHSS scores and the levels of NPY, CGRP, S100β, NSE,GFAP in the observation group were significantly better than those in the control group （ P〈0.05 ） .The MMSE scores and MoCA scores of the cognitive function in the observation group were significantly higher than those of the control group （ P〈0.05 ） . The GOS scores, KPS scores and Barthel index scores in the observation group were significantly higher than those of the control group （ P〈0.05 ） .The total efficiency of clinical efficacy in the observation group was significantly higher than the control group （ 81.40% vs 61.90%, P〈0.05 ） .There was no significant difference in the incidence of adverse reactions between two groups （ P〉0.05 ） . C

关 键 词：亚低温 复方脑肽节苷脂注射液 重症颅脑损伤 临床疗效 生活质量 

分 类 号：R651[医药卫生—外科学]