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目的观察血栓通对颅外伤合并多发性肋骨骨折患者的临床疗效。方法 66例颅外伤合并多发性肋骨骨折患者随机分为对照组33例和试验组33例。2组均实施手术纠正及持续吸氧、降颅压、神经营养支持、纠正水电解质紊乱、对症治疗等治疗。试验组在此基础上,静脉滴注血栓通注射液5 m L,溶于5%葡萄糖溶液250 m L,每日1次,持续14 d。比较2组患者治疗前、治疗7,14 d后疼痛评分、血氧饱和度变化和神经功能缺损程度评分;根据患者病情分为Ⅰ、Ⅱ、Ⅲ级,比较各级患者呼吸机使用时间、止痛药使用时间及住院时间。结果治疗7,14 d后,试验组的疼痛视觉模拟评分(VAS)分别为(2.33±0.51),(1.20±0.38)分,对照组的VAS分别为(7.05±1.39),(2.81±0.40)分;试验组神经功能缺损程度评分量表(NDS)评分分别为(10.70±2.99),(8.06±3.38)分,对照组的NDS评分分别为(15.84±4.62),(11.29±2.58)分,差异有统计学意义(P<0.05)。治疗7,14 d后,试验组的动脉血氧饱和度(SpO_2)分别为(90.36±3.55)%,(95.52±4.07)%;对照组的Sp O2分别为(89.81±3.42)%,(94.71±3.96)%,2组与治疗前相比,差异均有统计学意义(均P<0.05)。试验组Ⅰ、Ⅱ、Ⅲ级患者呼吸机使用时间分别为0,(1.13±0.96),(4.02±3.70)d;对照组Ⅰ、Ⅱ、Ⅲ级患者呼吸机使用时间分别为0,(4.59±3.05),(7.96±6.13)d;试验组Ⅰ、Ⅱ、Ⅲ级患者止痛药使用时间分别为(2.09±0.58),(4.71±0.83),(7.09±1.25)d,对照组Ⅰ、Ⅱ、Ⅲ级患者止痛药使用时间分别为(4.31±1.07),(8.20±3.55),(13.26±5.81)d;试验组Ⅰ、Ⅱ、Ⅲ级患者住院时间分别为(10.69±3.75),(15.36±8.22),(18.31±5.07)d,对照组Ⅰ、Ⅱ、Ⅲ级患者住院时间分别为(17.26±3.58),(19.39±5.42),(30.05±2.44)d,2组差异有统计学意义(P<0.05)。2组均未发生药物不良反应。结论血栓通能够有效改善颅外伤合并多发性肋骨骨折患者临床症状,促进其神经功能及机体状态的恢复,有助于缩短住院时间和止痛药物用量,对患者预后质量的改善具有积极作用。
Objective To observe the clinical effect of Xueshuantong on patients with craniocerebral injury complicated with multiple rib fractures. Methods 66 cases of craniocerebral injury complicated with multiple rib fractures were randomly divided into control group (33 cases) and experimental group (33 cases). Two groups were performed surgical correction and continuous oxygen, reducing intracranial pressure, neurotrophic support, correct water and electrolyte disorders, symptomatic treatment. On this basis, the experimental group received intravenous injection of Xueshuantong injection at a concentration of 5 mL, dissolved in 250 mL of 5% dextrose solution once daily for 14 days. The scores of pain, oxygen saturation and neurological deficit were compared between the two groups before treatment and after 7 and 14 days of treatment. The patients were divided into Ⅰ, Ⅱ and Ⅲ stages according to the patient’s condition, Drug use time and hospital stay. Results After 7 and 14 days of treatment, the pain visual analogue scale (VAS) of the experimental group was (2.33 ± 0.51) and (1.20 ± 0.38) respectively, while that of the control group was (7.05 ± 1.39) and (2.81 ± 0.40) The score of NDS in the experimental group was (10.70 ± 2.99) and (8.06 ± 3.38) respectively, while that in the control group was (15.84 ± 4.62) and (11.29 ± 2.58) respectively, The difference was statistically significant (P <0.05). SpO2 was (90.36 ± 3.55)% and (95.52 ± 4.07)% respectively in the experimental group after treatment for 7 and 14 days, while that in the control group was (89.81 ± 3.42)% and (94.71 ± 3.96)%. There were significant differences between the two groups before treatment (all P <0.05). The duration of use of ventilator in group Ⅰ, Ⅱ and Ⅲ of test group was 0 (1.13 ± 0.96) and (4.02 ± 3.70) d, respectively; the duration of use of ventilator in control group Ⅰ, Ⅱ and Ⅲ were 0 and 4.59 ± 3.09), (7.96 ± 6.13) d, respectively. The duration of painkillers used in group Ⅰ, Ⅱ and Ⅲ were (2.09 ± 0.58), (4.71 ± 0.83) and The duration of use of analgesics was (4.31 ± 1.07) and (8.20 ± 3.55) days and (13.26 ± 5.81) days respectively in patients with grade Ⅲ, while the length of stay in patients with grade Ⅰ, Ⅱ and Ⅲ were (10.69 ± 3.75) and (15.36 ± 8.22) and (18.31 ± 5.07) d, respectively. The length of stay in control group Ⅰ, Ⅱ and Ⅲ were (17.26 ± 3.58), (19.39 ± 5.42) and (30.05 ± 2.44) days respectively. There was significant difference between the two groups P <0.05). No adverse drug reactions occurred in both groups. Conclusion Xueshuantong can effectively improve the clinical symptoms of craniocerebral injury patients with multiple rib fractures, promote their neurological function and recovery of the body state, and help to shorten the length of hospital stay and the amount of analgesic drugs, which has a positive effect on the prognosis quality of patients.