艾司洛尔治疗重型颅脑损伤合并脑心综合征的临床效果观察  

Clinical effect of esmolol on severe craniocerebral injury complicated with brain-heart syndrome

作　　者：黄典[1] 江淇 张磊[1] HUANG Dian;JIANG Qi;ZHANG Lei(Department of Critical Care Medicine,Liuzhou People′s Hospital,Liuzhou 545006,China)

机构地区：[1]广西柳州市人民医院重症医学科,柳州市545006

出　　处：《广西医学》2020年第16期2088-2091,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z20190015);广西柳州市人民医院院内科研基金(lryjj201910)。

摘　　要：目的观察艾司洛尔治疗重型颅脑损伤并发脑心综合征的临床效果。方法将60例重型颅脑损伤并发脑心综合征患者随机分为治疗组和对照组,每组30例。两组患者均给予常规治疗,治疗组加用艾司洛尔治疗,疗程均为1周。观察两组治疗前、治疗1周后格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、颅内压及血清心肌钙蛋白I(cTnI)、肌酸激酶、磷酸肌酸激酶同工酶(CK-MB)水平,并比较两组治疗1周后心电图疗效,以及出院后3个月按格拉斯哥结局量表(GOS)评分评估预后情况。结果治疗后,治疗组GCS评分高于治疗前及对照组,NIHSS评分、颅内压、cTnI、肌酸激酶、CK-MB水平低于治疗前及对照组(P<0.05),对照组治疗前后上述指标差异无统计学意义(P>0.05)。治疗组心电图疗效优于对照组,预后良好率高于对照组(P<0.05)。结论在常规治疗的基础上加用艾司洛尔治疗重型颅脑损伤并发脑心综合征,有利于患者神经功能及心脏损伤的恢复,改善预后。Objective To observe the clinical effect of esmolol on severe craniocerebral injury complicated with brain-heart syndrome.Methods Sixty patients with severe craniocerebral injury complicated with brain-heart syndrome were randomly divided into treatment group and control group,with 30 cases in each group.Both groups were given conventional treatment,the treatment group received additional esmolol,and the treatment lasted for one week in both groups.The Glasgow Coma Scale(GCS)scores and the National Institute of Health Stroke Scale(NIHSS)scores,intracranial pressure,serum cardiac troponin I(cTnI),creatine kinase and creatinine kinase isoenzyme MB(CK-MB)levels before treatment and one week after treatment were observed in the two groups;besides,electrocardiography efficacy one week after treatment,as well as prognosis assessed by the Glasgow Outcome Scale(GOS)score three months after discharge from hospital,was compared between the two groups.Results After treatment,the treatment group had higher GCS score,lower NIHSS score,lower intracranial pressure,and lower cTnI,creatine kinase and CK-MB levels as compare with the pre-treatment and the control group(P<0.05),in the control group pre-and post-treatment indices mentioned above showed no statistically significant difference(P>0.05).The treatment group exhibited superior electrocardiography efficacy and higher rate of good prognosis than the control group(P<0.05).Conclusion Additional esmolol therapy based on conventional treatment might be in favor of patients′recovery of neurological function and cardiac injury and improve prognosis in the treatment of severe craniocerebral injury complicated with brain-heart syndrome.

关 键 词：重型颅脑损伤 脑心综合征 艾司洛尔 

分 类 号：R651.15[医药卫生—外科学] R541[医药卫生—临床医学]