醒脑静注射液联合标准大骨瓣减压术治疗急性重型颅脑损伤患者的疗效及血清炎性因子水平分析  

Treatment efficacy and serum inflammatory factor levels in acute severe traumatic brain injury treated by Xingnaojing injection and standard decompressive craniectomy with large bone-flap fenestration

作　　者：丁广俊 张海军 李海洋[3] Ding Guangjun;Zhang Haijun;Li Haiyang(Department of Neurosurgery,Tongxu First Hospital,Kaifeng 475400,China;Department of Neurosurgery,Kaifeng Central Hospital,Henan475000,China;Department of Neurosurgery,Henan ProvincialPeople′sHospital,Zhengzhou 450000,China)

机构地区：[1]河南省通许第一医院神经外科,开封475400 [2]河南省开封市中心医院神经外科,475000 [3]河南省人民医院神经外科,郑州450000

出　　处：《中国药物与临床》2022年第3期234-237,共4页Chinese Remedies & Clinics

摘　　要：目的分析醒脑静注射液联合标准大骨瓣减压术治疗急性重型颅脑损伤(STBI)患者的疗效及对血清炎性因子水平的影响。方法回顾性分析河南省通许第一医院2018年10月至2020年8月65例急性STBI患者,依照治疗方案不同分组。观察组(33例)接受醒脑静注射液联合标准大骨瓣减压术治疗,对照组(32例)接受标准大骨瓣减压术治疗,比较2组治疗效果。结果①疗效:2组治疗总有效率对比,观察组较对照组高(P<0.05);②临床症状积分:治疗后,与对照组对比,观察组临床症状积分较低(P<0.05);③血清炎性因子水平:治疗后,观察组血清白细胞介素(IL)-2、IL-6、肿瘤坏死因子(TNF)-α、超敏C反应蛋白(hs-CRP)均较对照组低(P<0.05);④血清神经因子水平:治疗后,观察组血清神经胶质纤维酸性蛋白(GFAP)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)均低于对照组(P<0.05);⑤并发症:观察组并发症发生率较对照组低(P<0.05)。结论醒脑静注射液联合标准大骨瓣减压术治疗急性STBI,效果显著,能有效改善患者临床症状,降低血清炎性因子水平,改善神经因子水平,且并发症少。Objective To analyze the treatment efficacy and serum inflammatory factor levels in acute se-vere traumatic brain injury(STBI)treated by Xingnaojing injection(XNJI)and standard decompressive craniecto-my with large bone-flap fenestration.Methods A retrospective study was conducted,including 65 patients with acute STBI in Tongxu First Hospital between October 2018 and August 2020.The patients were assigned to two groups according to treatments.The study group(n=33)received XNJI and standard decompressive craniectomy with large bone flap fenestration,while the control group(n=32)received the standard decompressive craniectomy alone.The two groups were compared for treatment efficacy and serum levels of in flammatory factor levels.Re-sults①The total rate of effective treatment was higher in the study group than that in the control group(P<0.05).②After treatment,clinical symptom score in the study group was lower compared with the control group(P<0.05).③After treatment,the study group showed lower levels of serum interleukin(IL)-2,IL-6,tumor necrosis fac-tor(TNF)-α,and high-sensitivity C-reactive protein(hs-CRP)than those in the control group(P<0.05).④Compari-son of neurotrophic factors showed that,after treatment,the study group showed lower levels of serum glial fibril-lary acidic protein(GFAP),myelin basic protein(MBP),and neuron-specific enolase(NSE)than those in the con-trol group(P<0.05).⑤The incidence of complications was lower in the study group than that in the control group(P<0.05).Conclusion XNJI combined with standard decompressive craniectomy with large bone-flap fenestration is significantly effective for treatment of acute STBI,leading to remarkable improvements in clinical symptoms,serum levels of inflammatory factors and neurotrophic factors,and fewer complications.

关 键 词：减压术 外科 颅脑损伤 活化白细胞黏附分子 炎性因子 醒脑静注射液 

分 类 号：R651.15[医药卫生—外科学]