集束化方案治疗重度脑损伤患者并发阵发性交感神经过度兴奋综合征的效果  

The effect of clustering scheme in treatment of patients with severe brain injury complicated with paroxysmal sympathetic hyperactivity syndrome

作　　者：李佳霖[1] 来永光 张建斌[1] LI Jialin;LAI Yongguang;ZHANG Jianbin(The Second Department of Neurosurgery,Pingdu People’s Hospital,Shandong,Pingdu 266700,China)

机构地区：[1]山东省平度市人民医院神经外二科,山东平度266700

出　　处：《中国医药科学》2022年第3期173-176,共4页China Medicine And Pharmacy

基　　金：山东省青岛市卫生科技计划项目(2020-WJZD259)。

摘　　要：目的研究集束化方案治疗重度脑损伤患者并发阵发性交感神经过度兴奋(PSH)综合征的效果。方法选取2019年11月至2021年6月平度市人民医院收治的重度脑损伤并发阵发性交感神经过度兴奋综合征患者83例。按随机数字表法分为对照组(n=41)及观察组(n=42)。对照组采用常规方法治疗,观察组在对照组治疗基础上加用集束化方案治疗。观察两组患者血液指标、颅内压(ICP)、临床指标及神经功能。结果治疗后两组内皮素(ET)、ICP、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均有所下降,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后观察组机械通气时间、ICU住院时间低于对照组,差异有统计学意义(P<0.05);两组患者呼吸机相关性肺炎(VAP)发生率比较,差异无统计学意义(P>0.05);治疗7、14 d后神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)及神经丝蛋白H(NF-H)水平均有所下降,且观察组低于对照组,差异有统计学意义(P<0.05)。结论集束化方案应用于重度脑损伤并发阵发性交感神经过度兴奋综合征患者治疗中,可有效降低患者颅内压,减轻炎症反应及脑部水肿,改善患者神经功能,安全性较高。Objective To study the efficacy of clustering scheme in the treatment of patients with severe brain injury complicated with paroxysmal sympathetic hyperactivity(PSH)syndrome.Methods A total of 83 patients with severe brain injury complicated with PSH syndrome admitted to Pingdu People’s Hospital from November 2019 to June 2021 were selected as research subjects.They were divided into the control group(n=41)and the observation group(n=42)based on the random number table method.The control group was treated with conventional methods,while the observation group was treated with clustering scheme based on the treatment of the control group.The blood index,clinical index,intracranial pressure(ICP)and neurological function of the two groups were observed.Results After treatment,the levels of endothelin(ET),ICP,C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)decreased in both groups,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the mechanical ventilation time and hospital stay in the intensive care unit(ICU)in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was no significant difference in the incidence of ventilator-associated pneumonia(VAP)between the two groups(P>0.05).The levels of neuron-specific enolase(NSE),central nerve-specific protein(S100β)and neurofilament protein H(NF-H)decreased after 7 and 14 days of treatment,and the levels in the observation group was lower than those in the control group,with statistically significant differences(P<0.05).Conclusion The application of clustering scheme can effectively reduce intracranial pressure,alleviate inflammatory reaction and brain edema,and improve neurological function of patients with severe brain injury complicated with PSH syndrome,with high safety.

关 键 词：集束化方案 重度脑损伤 阵发性交感神经过度兴奋综合征 神经功能 

分 类 号：R651[医药卫生—外科学] R741[医药卫生—临床医学]