论文部分内容阅读
目的探讨带颞肌蒂颅骨成形联合自体干细胞动员及综合康复治疗重型颅脑损伤后神经功能障碍的临床疗效。方法重型颅脑损伤术后患者95例,随机分为对照组47例和观察组48例,对照组行带肌蒂颅骨成形+综合康复治疗,观察组在对照组治疗基础上给予自体干细胞动员(重组人粒细胞集落刺激因子和粒巨噬细胞集落刺激因子联合辛伐他汀)治疗;治疗后3个月比较2组临床疗效。结果治疗3个月后观察组Barthel指数评分(78.42±13.09)和Glasgow预后评分(4.89±0.83)均明显高于对照组(65.61±18.36)、(3.04±0.76)(P<0.05);治疗3周后,观察组外周血CD34+CD133+占外周单核细胞比率((6.12±1.31)%)高于对照组((2.24±0.26)%)(P<0.01),治疗中均未出现明显不良反应。结论带肌蒂颅骨成形联合干细胞动员及综合康复治疗重型颅脑损伤安全、有效,对改善患者神经功能和预后有促进作用。
Objective To investigate the clinical effects of mobilization of skull with temporal muscle pedicle and autologous stem cell mobilization and comprehensive rehabilitation on neurological dysfunction after severe craniocerebral injury. Methods Ninety-five patients with severe craniocerebral injury were randomly divided into control group (n = 47) and observation group (n = 48). The control group was treated with skull formation with muscular pedicle and comprehensive rehabilitation. The observation group was given autologous stem cell mobilization Recombinant human granulocyte colony stimulating factor and granulocyte colony stimulating factor combined with simvastatin); 3 months after treatment, the clinical efficacy of the two groups were compared. Results After 3 months of treatment, Barthel index score (78.42 ± 13.09) and Glasgow prognostic score (4.89 ± 0.83) in the observation group were significantly higher than those in the control group (65.61 ± 18.36, 3.04 ± 0.76) (P <0.05) The ratio of CD34 + CD133 + peripheral mononuclear cells (6.12 ± 1.31%) in the peripheral blood of the observation group was significantly higher than that of the control group (2.24 ± 0.26%) (P <0.01), but there was no obvious adverse reaction . Conclusion It is safe and effective to mobilize the skull with muscle pedicle and to mobilize the stem cells for comprehensive rehabilitation in the treatment of severe craniocerebral injury. It can promote the neurological function and prognosis of the patients.