摘要：
目的 探讨纳洛酮联合小牛血清去蛋白治疗急性颅脑损伤的临床效果.方法 选取2015年8月—2017年8月重庆市开州区人民医院收治的急性颅脑损伤患者122例,随机分为对照组(61例)和治疗组(61例).对照组静脉滴注小牛血清去蛋白注射液,30 mL加入5％葡萄糖注射液250 mL,1次/d.治疗组在对照组基础上静脉滴注盐酸纳洛酮注射液,0.3 mg/(kg·d).两组患者均连续治疗7 d.观察两组临床疗效,比较治疗前后两组格拉斯哥昏迷量(GCS)评分、血液流变学指标、及肿瘤坏死因子(TNF)-α、IL-6和神经元特异性烯醇化酶(NSE)水平.结果 治疗后,对照组和治疗组临床总有效率分别为78.7％、93.4％,两组比较差异具有统计学意义(P<0.05).治疗后,两组GCS评分中运动、语言、睁眼及GCS总评分均显著升高(P<0.05);且治疗组GCS评分明显高于对照组(P<0.05).治疗后,两组全血黏度(WBV)、血浆黏度(PV)和红细胞聚集指数(EAI)值均显著下降(P<0.05);且治疗组比对照组降低的更显著(P<0.05).治疗后,两组血清TNF-α、IL-6、NSE水平均明显降低(P<0.05);且治疗组比对照组降低的更明显,(P<0.05).结论 纳洛酮联合小牛血清去蛋白治疗急性颅脑损伤可迅速缓解患者症状体征,减轻炎性损伤,改善神经功能,具有一定的临床推广应用价值.%Objective To investigate the clinical effect of naloxone combined with bovine serum albumin in treatment of acute craniocerebral injury. Methods Patients (112 cases) with acute craniocerebral injury in the People's Hospital of Kaizu District,CQ from August 2015 to August 2017 were randomly divided into control (61 cases) and treatment (61 cases) groups. Patients in the control group were iv administered with Deproteinised Calf Blood Serum Injection, 30 mL added into 5％ glucose injection 250 mL, once daily. Patients in the treatment group were iv administered with Naloxone Hydrochloride Injection on the basis of the control group, 0.3 mg/(kg·d). Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the GCS score, hemorheological indexes, and TNF-α, IL-6, NSE levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.7％ and 93.4％, respectively, and there were differences between two groups (P < 0.05). After treatment, the motion, language, eyes open and total GCS scores in two groups were significantly increased (P < 0.05). And the GCS scores in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the WBV, PV, EAI levels in two groups were significantly decreased (P < 0.05). And the hemorheological indexes in the treatment group decreased more significantly than those in the control group (P < 0.05). After treatment, the TNF-α, IL-6 and NSE levels in two groups were significantly decreased (P < 0.05). And these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Naloxone combined with bovine serum albumin in treatment of acute craniocerebral injury can rapidly relieve symptoms and signs and reduce inflammatory injury, and improve neurological function, which has a certain clinical application value.
