摘要
目的探究纳美芬治疗儿童急性中重型颅脑损伤疗效及脑保护作用。方法选取2015年4月至2017年4月收治的90例急性中、重型颅脑损伤的儿童作为研究对象,按照随机数字法将其分为观察组和对照组,每组45例。对照组患者使用降颅压、营养支持、抗感染等常规治疗方法进行治疗,观察组患者在对照组的基础上加用纳美芬进行治疗,2组患者连续治疗2周后观察患者的治疗效果以及对患者脑保护作用。结果观察组总有效率91.1%显著高于对照组总有效71.1%(P<0.05)。2组患者治疗前大脑中动脉收缩期峰值和大脑中动脉舒张期末值比较差异无统计学意义(P>0.05),而经过治疗后4h再进行检测,2组患者情况均有所改善,但观察组明显优于对照组,2组比较差异有统计学意义(P<0.05)。入选患者治疗前-EP、DynAI-13、S100B蛋白、NSE比较差异无统计学意义(P>0.05),治疗后14d后观察组与对照组-EP、DynAI-13、S100B蛋白、NSE比较差异有统计学意义(P<0.05)。观察组与对照组经过治疗后在呼吸异常和心率异常上比较(P<0.05),颅内压分布情况比较(P<0.05)。观察组出现总不良反应率22.2%,对照组总不良反应率20.0%,2组患者比较差异无统计学意义(P>0.05)。结论纳美芬对于急性中重型颅脑损伤儿童患者具有一定的脑保护作用,提高治疗的有效率,减少继发性脑损伤的发生率。临床上可推广使用。
Objective To investigate the curative effects and cerebral protective effects of nalmefene in treatment of acute moderate or severe craniocerebral injury in children.Methods A total of 90 children with acute moderate or severe craniocerebral injury who were admitted and treated in our hospital from April 2015 to April 2017 were enrolled in the study,who were divided into observation group(n=45)and control group(n=45)according to the random number method.The patients in control group were treated by conventional therapy,including intracranial pressure reduction,nutritional support and anti-infection,however,the patients in observation group,on the basis of control group,were treated by nalmefene,with a treatment course of 2 weeks for both groups.The clinical efficacy and the cerebral protective effects were observed and compared between the two groups.Results The total effective rate in observation group was significantly higher than that in control group(91.1%vs 71.1%,P<0.05).Before treatment there were no significant differences in peak systolic and end-diastole velocity of middle cerebral artery between the two groups(P>0.05).However after 4-hour treatment,the detection results showed that the above indexes were improved in both groups,moreover,the improvement status in observation group was superior to that in control group(P<0.05).Before treatment there were no significant differences in EP,DynAI-13,S100B protein and NSE between the two groups(P>0.05).After 14-day treatment,there were significant differences in EP,DynAI-13,S100B protein and NSE between the two groups(P<0.05).Moreover there were significant differences in respiratory abnormalities,heart rate abnormalities and distribution of intracranial pressure after treatment between the two groups(P<0.05).However there were no significant differences in the incidence rates of the adverse reactions between the two groups(P>0.05).Conclusion Nalmefene has certain cerebral protective effects on acute moderate or severe craniocerebral injury in children,which c
作者
张亦鹏
ZHANG Yipeng(Department of Neurosurgery,Children’s Hospital of Wuxi City,Jiangsu,Wuxi 214000,China)
出处
《河北医药》
CAS
2019年第20期3114-3117,共4页
Hebei Medical Journal
关键词
纳美芬
颅脑损伤
儿童
临床疗效
脑保护
nalmefene
craniocerebral injury
children
clinical efficacy
cerebral protection
