乌司他丁联合醒脑静注射液治疗重度颅脑损伤的临床研究

发布时间：2018-04-28 04:23

本文选题：乌司他丁注射液 + 醒脑静注射液　；参考：《中国药房》2017年29期

【摘要】：目的:探讨乌司他丁注射液联合醒脑静注射液治疗重度颅脑损伤的临床效果及安全性。方法:选取2014年9月-2015年11月我院收治的重度颅脑损伤患者120例作为研究对象,按照治疗方案将患者分为乌司他丁组、醒脑静组和联合组,各40例。3组患者入院后均及时给予常规治疗。在常规治疗基础上,乌司他丁组患者给予乌司他丁注射液20万单位,ivgtt,bid;醒脑静组患者给予醒脑静注射液20 mL,ivgtt,qd;联合组患者给予乌司他丁注射液联合醒脑静注射液,用法同上(两药间隔1 h滴注)。3组患者均连续治疗14 d。观察3组患者治疗前后的血清炎症因子[C反应蛋白(CRP)、白细胞介素1(IL-1)、IL-6和肿瘤坏死因子α(TNF-α)]和颅脑损伤血清学指标[神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)和S100B蛋白(S100B)]水平、格拉斯哥昏迷(GCS)评分、治疗后的格拉斯哥预后(GOS)评分,并记录治疗过程中不良反应发生情况。结果:治疗前,3组患者血清炎症因子、颅脑损伤血清学指标和GCS评分比较,差异均无统计学意义(P0.05)。治疗后,3组患者炎症因子水平均较治疗前显著降低,乌司他丁组显著低于醒脑静组,联合组显著低于两单药组,差异均有统计学意义(P0.05);3组患者颅脑损伤血清学指标水平和GCS评分均显著改善,且联合组均显著优于两单药组,差异均有统计学意义(P0.05),但乌司他丁组与醒脑静组比较,差异均无统计学意义(P0.05)。治疗后6个月,联合组患者GOS评分[(4.17±0.81)分]显著优于乌司他丁组[(3.05±0.97)分]和醒脑静组[(2.97±0.89)分],差异均有统计学意义(P0.05);但乌司他丁组与醒脑静组比较,差异无统计学意义(P0.05)。治疗过程中,联合组患者的不良反应发生率(27.50%)显著低于乌司他丁组(50.00%)和醒脑静组(42.50%),差异均有统计学意义(P0.05);但乌司他丁组与醒脑静组比较,差异无统计学意义(P0.05)。结论:乌司他丁注射液联合醒脑静注射液可显著降低重度颅脑损伤患者血清炎症因子水平,减轻颅脑损伤,保护脑组织,改善患者近期预后,且安全性较高。
[Abstract]:Objective: to investigate the clinical effect and safety of ulinastatin injection combined with Xingnaojing injection in the treatment of severe craniocerebral injury. Methods: 120 patients with severe craniocerebral injury admitted in our hospital from September 2014 to November 2015 were divided into three groups: ulinastatin group, Xingnaojing group and combined group. 40 patients in each group were given routine treatment in time after admission. On the basis of routine treatment, patients in ulinastatin group were given ulinastatin injection 200000 units iv Gttbidin; Xingnaojing group received Xingnaojing injection 20 mL iv QD; combined group patients were given ulinastatin injection combined with Xingnaojing injection, and patients in xingnaojing group were given urinastatin injection combined with Xingnaojing injection. The two drugs were treated continuously for 14 days. The levels of serum inflammatory cytokines [C-reactive protein (C-reactive protein), interleukin-1 (IL-1TNF- 伪) and tumor necrosis factor 伪 -TNF- 伪] and serum levels of neuron-specific enolase (NSEP), myelin basic protein (MBP) and S100B protein (S100B) were measured before and after treatment in the three groups. Glasgow coma score, Glasgow prognosis score and adverse reactions were recorded. Results: there was no significant difference in serum inflammatory factors, serum indexes of craniocerebral injury and GCS score between the three groups before treatment (P 0.05). After treatment, the levels of inflammatory factors in the three groups were significantly lower than those before treatment, the levels of inflammatory factors in the ulinastatin group were significantly lower than those in the Xingnaojing group, and those in the combined group were significantly lower than those in the two single drug groups. There were significant differences in serum index level and GCS score of patients with craniocerebral injury. The combined group was significantly better than the two single drug groups (P 0.05), but the Ulinastatin group and Xingnaojing group were significantly better than those in the control group, but there was no significant difference between Ulinastatin group and Xingnaojing group. The difference was not statistically significant (P 0.05). Six months after treatment, the GOS score of the combined group [4.17 卤0.81] was significantly higher than that of the ulinastatin group [3.05 卤0.97] and the Xingnaojing group [2.97 卤0.89], but there was no significant difference between the ulinastatin group and the Xingnaojing group. In the course of treatment, the incidence of adverse reactions in combination group (27.50) was significantly lower than that in ulinastatin group (50.00kb) and Xingnaojing group (42.50%), the difference was statistically significant (P 0.05), but there was no significant difference between ulinastatin group and Xingnaojing group (P 0.05). Conclusion: ulinastatin injection combined with Xingnaojing injection can significantly reduce the level of serum inflammatory factors in patients with severe craniocerebral injury, alleviate brain injury, protect brain tissue, improve the short-term prognosis of patients, and have higher safety.
【作者单位】：南阳市中心医院神经外一科;
【分类号】：R651.15

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