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目的:观察用血液稀释加川芎嗪治疗脑外伤患者的临床效果。方法:选取2012年4月—2014年3月于我院就诊的脑外伤患者94例,随机分为对照组和治疗组患者各47例。两组患者入院后均给予常规吸氧、降颅内压、营养、抗生素、脱水等基础治疗;治疗组患者则在对照组治疗的基础上给予血液稀释加川芎嗪治疗,连续治疗10 d。观察两组患者治疗后的临床症状缓解情况,用神经功能缺损程度评分量表NIHSS、格拉斯哥昏迷量表GCS、格拉斯哥预后量表GOS对患者的神经功能缺损程度、昏迷严重程度、预后情况进行评价;检测患者治疗前后血清hs-CRP、IL-1β、IL-6等炎性因子水平的变化及血浆一氧化氮(NO)、超氧化物歧化酶(SOD)含量。结果:两组患者临床症状均得到缓解,神经功能有所提高、昏迷情况有所改善,预后良好,神经功能缺损程度NIHSS评分有所降低,格拉斯哥昏迷量表GCS评分有所升高,以治疗组的改善尤为突出,治疗组的预后GOS评分更高,差异有统计学意义(P<0.05);治疗后两组患者的血清hs-CRP、IL-1β、IL-6炎性因子水平均较同组治疗前有所下降,以治疗组的下降更为突出,差异有统计学意义(P<0.05);治疗后两组患者的血浆一氧化氮(NO)水平有所降低,超氧化物歧化酶(SOD)含量有所升高,变化幅度以治疗组尤为明显,差异有统计学意义(P<0.05)。结论:血液稀释加川芎嗪能有效缓解脑外伤患者的临床症状,改善神经功能,降低炎性因子水平,降低血浆NO活性,提高SOD水平,预后良好,值得临床深入研究运用。
Objective: To observe the clinical effect of hemodilution combined with ligustrazine on traumatic brain injury. Methods: 94 patients with traumatic brain injury in our hospital from April 2012 to March 2014 were randomly divided into control group and treatment group, 47 cases each. Both groups were given routine oxygen inhalation, intracranial pressure, nutrition, antibiotics, dehydration and other basic treatment; the patients in the treatment group were treated with hemodilution plus ligustrazine on the basis of the control group, and the treatment was continued for 10 days. The clinical symptoms of the two groups were observed. The NIHSS, Glasgow Coma Scale GCS and Glasgow Outcome Scale GOS were used to evaluate the degree of neurological deficit, the severity of coma and the prognosis of the patients. The changes of serum hs-CRP, IL-1β, IL-6 and other inflammatory cytokines and the levels of plasma nitric oxide (NO) and superoxide dismutase (SOD) were measured before and after treatment. Results: The clinical symptoms of both groups were relieved, the neurological function was improved, the coma was improved, the prognosis was good, the NIHSS score of neurological deficit was decreased, GCS score of Glasgow coma scale increased, (P <0.05). The levels of serum hs-CRP, IL-1β and IL-6 in the two groups were significantly higher than those in the control group (P <0.05). After treatment, the level of plasma nitric oxide (NO) in both groups decreased, and the levels of superoxide dismutase (SOD) content was increased, the magnitude of change in the treatment group is particularly evident, the difference was statistically significant (P <0.05). Conclusion: Hemodilution combined with ligustrazine can effectively relieve the clinical symptoms, improve the neurological function, reduce the level of inflammatory cytokines, decrease the activity of NO in plasma and increase the level of SOD in patients with traumatic brain injury. The prognosis is good and worthy of clinical study.