摘要
目的探究康复训练联合纳美芬对重型颅脑损伤急性期脑血管痉挛的治疗效果及对ET-1、NO的影响。方法选择2015年1月~2017年12月在本院救治的重型颅脑损伤患者74例作为研究对象,按随机数字表法分为对照组和观察组,每组各37例,对照组采用常规治疗联合康复训练,观察组在对照组基础上予以纳美芬治疗,连续治疗2周,比较两组患者治疗期间脑血流速度、脑血管痉挛(cerebral vasospasm,CVS)发生情况、格拉斯哥昏迷评分(glasgow coma scale,GCS)、内皮素-1(endothelin-1,ET-1)及一氧化氮(nitric oxide,NO)的含量、Fugl-Meyer量表评分(fugl-meyer assessment,FMA)以及Barthel指数评定量表(barthel index,BI)评分。结果经治疗后两组患者颅内各血管血流速度均明显下降,且观察组各血流速度明显低于对照组(P<0.05),观察组CVS发生率明显低于对照组(P<0.05),经治疗后观察组GCS评分明显高于对照组(P<0.05),观察组脑脊液ET-1水平明显低于对照组,NO含量明显高于对照组(P<0.05),经治疗后,两组患者FMA、BI评分均明显改善,但观察组患者改善更显著(P<0.05)。结论康复训练联合纳美芬对重型颅脑损伤患者可有效减轻脑组织的继发性损伤,有良好的脑保护作用,减少脑血管痉挛的发生,促进意识的恢复,降低脑脊液ET-1水平,提高NO水平,提高患者生活自理能力。
Objective To explore the effect of rehabilitation training combined with Nalmefene on acute cerebral vasospasm of severe craniocerebral injury and its effect on endothelin-1(ET-1)and nitric oxide(NO)production.Methods Seventy four patients with severe craniocerebral injury in the hospital were selected from January 2015 to December 2017.The patients were randomly divided into the control group(group A)and the observation group(group B),with 37 cases in each.The group A was treated with routine treatment combined with rehabilitation training whereas group B was additionally given Nalmefene.After 2 weeks of treatments,the two groups of patients were compared for blood flow velocity,incidence of cerebral vasospasm,Glasgow coma score,ET-1 and NO level,Fugl-Meyer assessment scale(FMA),and the Barthel index rating scale(BI)score.Results The blood flow velocity of all the patients in the two groups decreased following the treatments,particularly in group B when compared with the control(P<0.05).The incidence of CVS in group B was significantly lowered(P<0.05).After treatments,the GCS score of group B was significantly elevated(P<0.05).The ET-1 level of the cerebrospinal fluid in group B was decreased and the NO production was notably higher than that of the control(P<0.05).Generally,the scores of FMA and BI in both groups were improved but more obviously in group B than group A(P<0.05).Conclusion The combined therapy of rehabilitation training and Nalmefene may effectively reduce the secondary injury of brain tissues and help for amelioration of cerebral vasospasm,promotion of the recovery of consciousness and reduction of the ET-1 expression.
作者
魏晋琪
夏晓萍
路楷
周先举
WEI Jin-qi;XIA Xiao-ping;LU Kai(Storehouse of Foreign Medicine,Jiangyin TCM Hospital,Jiangsu 214400)
出处
《临床输血与检验》
CAS
2020年第4期408-412,共5页
Journal of Clinical Transfusion and Laboratory Medicine
基金
国家自然科学基金项目(No.81471338)
江苏省中医药局科技项目(No.LB11014)资助。
关键词
重型颅脑损伤
脑血管痉挛
康复训练
纳美芬
内皮素-1
一氧化氮
Severe craniocerebral injury
Cerebral vasospasm
Rehabilitation training
Nalmefene
Endothelin-1
Nitricoxyde
