醒脑静辅助奥氮平治疗主动脉夹层腔内隔绝术后谵妄45例  

Treating 45 Cases of Delirium after the EVGE for Aortic Dissection by XingNaoJing Injection as AT and Olanzapine

作　　者：解鑫隆 徐朝军[1] 尹晓清[1] 王兆礼[1] 杨进[1] 程宇[1] 张胜康[1] XIE Xinlong;XU Chaojun;YIN Xiaoqing;WANG Zhaoli;YANG Jin;CHENG Yu;ZHANG Shengkang(Department of Cardiothoracic Surgery,the First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院心胸外科,湖南长沙410007

出　　处：《西部中医药》2018年第10期79-82,共4页Western Journal of Traditional Chinese Medicine

基　　金：湖南省中医药科研计划项目(编号201696);中医内科学省部共建教育部重点实验室开放基金支助项目(编号ZYNK201506)

摘　　要：目的:观察醒脑静辅助奥氮平治疗Stanford B型主动脉夹层腔内隔绝术后谵妄患者的临床疗效。方法:将90例患者随机分为对照组和观察组,每组45例。2组在治疗原发病的基础上给予奥氮平,口服或鼻饲,1次/d。观察组同时给予静滴醒脑静注射液,1次/d,2组均连续治疗1周。比较2组谵妄持续时间、术后住院时间、合并症发生率、住院期间病死率、不良反应发生情况以及患者谵妄确诊时(T_0)、治疗后24小时(T_1)、治疗后48小时(T_2)、治疗后76小时(T_3)的C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果:谵妄持续时间、术后住院时间观察组均短于对照组(P<0.05),住院期间合并症发生率观察组低于对照组(P<0.05),住院期间病死率2组比较,差异无统计学意义(P>0.05)。CRP、TNF-α、IL-6水平同组治疗后各时间节点较T_0时显著降低(P<0.05),并随时间的推移呈下降趋势;治疗后各时间节点观察组较对照组下降明显(P<0.05)。不良反应发生率2组比较,无明显差异。结论:醒脑静辅助奥氮平治疗Stanford B型主动脉夹层腔内隔绝术后谵妄的安全性及有效性方面均较单独使用奥氮平好。Objective： To observe clinical effects of XingNaoJing injection as ajunctive therapy （AT） andolanzapine in treating postoperative delirium of the patients with stanford B type aortic dissection who underwentendovascular graft exclusion （EVGE）. Methods： All 90 patients were randomized into the control group and theobservation group, 45 cases each group. Both groups were given olanzapine by oral administration or nasal feedingon the basic treatment for primary disease, once each day. The observation group accepted intravenous dripping ofXingNaoJing injection, once each day, both groups were treated for one week consecutively. Delirium duration,postoperative hospitalization times, the incidences of the complications, mortality rate during hospitalization period,the incidences of adverse reaction, and the levels of tumor growth factor 琢（TNF-琢）, interleukin6（IL-6） and C reactiveprotein（CRP） at the time when the patients were diagnosed as delirium（T0）, in 24 hours after treating（T1）, in 48 hoursafter treating （T2） and in 76 hours after treating （T3） were compared between both groups. Results： The observationgroup was shorter than the control group in delirium duration and postoperative hospitalization time（P〈0.05）, theobservation group was lower than the control group in the incidence of the complications during hospitalizationperiod（P〈0.05）, there was no obvious difference in the comparisons of mortality rate during hospitalization periodbetween both groups（P〉0.05）. The levels of CRP, TNF-琢 and IL-6 of the same group after treating at differenttimes reduced remarkably compared withT0 （P〈0.05）, they showed the decreasing tendency as the time went by;the decrease of the observation group was more obvious than that of the control group at different times after treating（P〈0.05）. There were no obvious difference in the comparisons of the incidence of adverse reaction between bothgroups. Conclusion： The safety and effectiveness of XingNaoJing in

关 键 词：谵妄 主动脉夹层 腔内隔绝术 醒脑静注射液 炎症因子 

分 类 号：R543.1[医药卫生—心血管疾病]