醒脑静联合纳洛酮在治疗重型颅脑损伤中的临床应用
摘要
目的:探讨醒脑静联合纳洛酮在重型颅脑损伤术后的临床应用。方法:将2013年10月-2017年4月在笔者所在医院神经外科住院的80例重型颅脑损伤患者随机分成两组,每组40例,对照组给予常规治疗,治疗组在常规治疗基础上加用醒脑静及纳洛酮注射液,连用15 d,观察两组治疗30 d内及随访3个月的临床疗效。结果:治疗组治疗30 d内的清醒例数、觉醒时间及随访3个月患者GOS评分均高于对照组,差异有统计学意义(P<0.05)。结论:醒脑静联合纳洛酮用于治疗重型颅脑损伤的治疗效果明显,具有积极临床意义。
引文
[1]赵继宗.神经外科学[M].第3版.北京:人民卫生出版社,2014:139-140.
[2]岳增花,齐玮.盐酸纳诺酮治疗内科危急重症急性昏迷疗效观察[J].中国现代药物应用,2015,9(13):142-143.
[3]Stenger R D,Schmidt S,Beyer B,et al.Use of the glasgow coma scale in pediatric craniocerebral trauma[J].Kinderarztl Prax,2013,61(10):359-364.
[4]中国医师协会神经外科医师分会,中国神经创伤专家委员会.中国颅脑创伤颅内压监测专家共识[J].中华神经外科杂志,2011,27(10):1073-1074.
[5]Suehiro E M D Ph D,Fujiyama Y,Koizumi H,et al.Directions for use of intracranial pressure monitoring in treatment of severe traumatic brain injury using data from the Japan Neurotrauma Data Bank[J].Journal of Neurotrauma,2017,34(14):4948.
[6]Aiolfi A,Benjamin E,Khor D,et al.Brain Trauma Foundation Guidelines for Intracranial Pressure Monitoring:Compliance and Effect on Outcome[J].World J Surg,2017,41(6):1543-1549.
[7]关宏,武变瑛,张丽娜.醒脑静对中重度颅脑损伤患者血清s Fractalkine含量的影响及临床意义[J].河北医药,2011,33(8):1129-1131.
[8]涂悦,杨细平,商崇智.醒脑静对颅脑创伤的保护作用[J].中国应用生理学杂志,2014,30(3):230-232.
[9]徐卡娅,刘沣,陈益民,等.大剂量醒脑静对重型颅脑损伤的治疗作用[J].贵阳医学院学报,2013,38(2):176-177.
[10]王寅安.醒脑静注射液对脑保护作用的临床研究[J].临床医药实践,2008,17(12):990-991.
[11]赵兴.醒脑静注射液在抢救急危重患者中的应用进展[J].天津药学,2012,24(4):57-59.
[12]郭晓明,刘文科.醒脑静注射液对重型颅脑损伤患者肠黏膜通透性及血浆二胺氧化酶的影响[J].中国老年学,2015,35(8):2114-2115.
[13]He X,Sandhu H K,Yang Y,et al.Neuroprotection against hypoxia/ischemia:δ-opioid receptor-mediated cellular/molecular events[J].Cellular&smolecular Life Sciences:cmls,2013,70(13):2291-2303.
[14]吴伟中.纳洛酮作用机制及临床应用探讨[J].海南医学,2010,21(10):112-114.
[15]Maria K,Kowalczyk J E,Malgorzata B,et al.Neuroprotective Potential of Biphalin,Multireceptor Opioid Peptide,Against Excitotoxic Injury in Hippocampal Organotypic Culture[J].Neurochemical Research,2011,36(11):2091.
[16]Podhaizer E M,Zou S,Fitting S,et al.Morphine and gp120 toxic interactions in striatal neurons are dependent on HIV-1 strain[J].Journal of Neuroimmune Pharmacology,2012,7(4):877-891.
[17]Ammon-Treiber S,Stolze D,Schr?der H,et al.Effects of opioid antagonists and morphine in a hippocampal hypoxia/hypoglycemia model[J].Neuropharmacology,2005,49(8):1160-1169.
[18]高嵘,单春雷.亚低温环境下盐酸纳洛酮注射液治疗重症颅脑损伤的临床研究[J].中国临床药理学杂志,2017,33(11):963-965.
[19]刘宇.醒脑静联合纳洛酮注射液治疗重型颅脑损伤的效果分析[J].当代医学,2014,20(34):137-138.
[20]王鹏宇,周广滨,李钊.醒脑静联合盐酸纳洛酮治疗重症颅脑损伤39例[J].中国药业,2014,23(18):108.
[21]杨俊,郭淋,覃进.醒脑静联合纳络酮注射液治疗重型颅脑损伤疗效观察[J].中国中医急症,2013,22(3):428-429.
[2]岳增花,齐玮.盐酸纳诺酮治疗内科危急重症急性昏迷疗效观察[J].中国现代药物应用,2015,9(13):142-143.
[3]Stenger R D,Schmidt S,Beyer B,et al.Use of the glasgow coma scale in pediatric craniocerebral trauma[J].Kinderarztl Prax,2013,61(10):359-364.
[4]中国医师协会神经外科医师分会,中国神经创伤专家委员会.中国颅脑创伤颅内压监测专家共识[J].中华神经外科杂志,2011,27(10):1073-1074.
[5]Suehiro E M D Ph D,Fujiyama Y,Koizumi H,et al.Directions for use of intracranial pressure monitoring in treatment of severe traumatic brain injury using data from the Japan Neurotrauma Data Bank[J].Journal of Neurotrauma,2017,34(14):4948.
[6]Aiolfi A,Benjamin E,Khor D,et al.Brain Trauma Foundation Guidelines for Intracranial Pressure Monitoring:Compliance and Effect on Outcome[J].World J Surg,2017,41(6):1543-1549.
[7]关宏,武变瑛,张丽娜.醒脑静对中重度颅脑损伤患者血清s Fractalkine含量的影响及临床意义[J].河北医药,2011,33(8):1129-1131.
[8]涂悦,杨细平,商崇智.醒脑静对颅脑创伤的保护作用[J].中国应用生理学杂志,2014,30(3):230-232.
[9]徐卡娅,刘沣,陈益民,等.大剂量醒脑静对重型颅脑损伤的治疗作用[J].贵阳医学院学报,2013,38(2):176-177.
[10]王寅安.醒脑静注射液对脑保护作用的临床研究[J].临床医药实践,2008,17(12):990-991.
[11]赵兴.醒脑静注射液在抢救急危重患者中的应用进展[J].天津药学,2012,24(4):57-59.
[12]郭晓明,刘文科.醒脑静注射液对重型颅脑损伤患者肠黏膜通透性及血浆二胺氧化酶的影响[J].中国老年学,2015,35(8):2114-2115.
[13]He X,Sandhu H K,Yang Y,et al.Neuroprotection against hypoxia/ischemia:δ-opioid receptor-mediated cellular/molecular events[J].Cellular&smolecular Life Sciences:cmls,2013,70(13):2291-2303.
[14]吴伟中.纳洛酮作用机制及临床应用探讨[J].海南医学,2010,21(10):112-114.
[15]Maria K,Kowalczyk J E,Malgorzata B,et al.Neuroprotective Potential of Biphalin,Multireceptor Opioid Peptide,Against Excitotoxic Injury in Hippocampal Organotypic Culture[J].Neurochemical Research,2011,36(11):2091.
[16]Podhaizer E M,Zou S,Fitting S,et al.Morphine and gp120 toxic interactions in striatal neurons are dependent on HIV-1 strain[J].Journal of Neuroimmune Pharmacology,2012,7(4):877-891.
[17]Ammon-Treiber S,Stolze D,Schr?der H,et al.Effects of opioid antagonists and morphine in a hippocampal hypoxia/hypoglycemia model[J].Neuropharmacology,2005,49(8):1160-1169.
[18]高嵘,单春雷.亚低温环境下盐酸纳洛酮注射液治疗重症颅脑损伤的临床研究[J].中国临床药理学杂志,2017,33(11):963-965.
[19]刘宇.醒脑静联合纳洛酮注射液治疗重型颅脑损伤的效果分析[J].当代医学,2014,20(34):137-138.
[20]王鹏宇,周广滨,李钊.醒脑静联合盐酸纳洛酮治疗重症颅脑损伤39例[J].中国药业,2014,23(18):108.
[21]杨俊,郭淋,覃进.醒脑静联合纳络酮注射液治疗重型颅脑损伤疗效观察[J].中国中医急症,2013,22(3):428-429.