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目的探讨亚低温联合中药治疗重型颅脑损伤的临床效果。方法将重型颅脑损伤患者170例采用随机数字表法分为观察组与对照组各85例,对照组给予常规微创血肿清除术与中药治疗,观察组在此基础上加用亚低温治疗。结果治疗后观察组有效率为94.1%,对照组为78.8%,2组比较差异有统计学意义(P<0.05)。治疗后2组的NIHSS评分与颅内压均较治疗前下降,差异有统计学意义(P<0.05),2组间差异亦有统计学意义(P<0.05)。2组治疗后血清脑源性神经细胞营养因子(BDNF)含量均呈上升趋势,差异有统计学意义(P<0.05),2组间差异亦有统计学意义(P<0.05)。2组治疗后出血量和水肿带呈下降趋势,差异有统计学意义(P<0.05),2组间差异亦有统计学意义(P<0.05)。结论亚低温联合中药治疗重型颅脑损伤能有效降低颅内压与减轻脑水肿、脑出血,发挥神经保护作用,从而提高治疗疗效,作用机制可能与提高脑源性神经细胞营养因子表达有关。
Objective To investigate the clinical effects of mild hypothermia combined with traditional Chinese medicine in the treatment of severe craniocerebral injury. Methods One hundred and seventy patients with severe craniocerebral injury were divided into observation group and control group by random number table method. The control group was given conventional minimally invasive hematoma and Chinese medicine. The observation group was treated with mild hypothermia. Results After treatment, the effective rate of the observation group was 94.1% and that of the control group was 78.8%. The difference between the two groups was statistically significant (P <0.05). NIHSS score and intracranial pressure in the two groups after treatment were significantly lower than those before treatment (P <0.05). There was also a significant difference between the two groups (P <0.05). The levels of serum BDNF in both groups showed an upward trend after treatment (P <0.05), and there was also a significant difference between the two groups (P <0.05). The blood loss and edema zone of the two groups showed a decreasing trend after treatment, the difference was statistically significant (P <0.05). There was also significant difference between the two groups (P <0.05). Conclusion Treatment of severe craniocerebral injury with mild hypothermia combined with traditional Chinese medicine can effectively reduce intracranial pressure and relieve cerebral edema and cerebral hemorrhage, and play a neuroprotective role to improve the curative effect. The mechanism may be related to enhancing the expression of trophic factors in brain-derived neurons.