神经节苷脂钠联合高压氧在颅脑损伤昏迷早期促醒中的效果观察

来源 :中华航海医学与高气压医学杂志 | 被引量 : 0次 | 上传用户:tyzhaoxiqing
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目的:了解神经节苷脂钠联合高压氧对重度颅脑损伤昏迷患者早期促醒的影响。方法:选取2018年3月至2019年9月南京医科大学附属淮安第一医院收治的90例重度颅脑损伤手术后继发迁延性昏迷患者,经患者家属知情同意并签署知情同意书,依据随机数字表法分为3组:高压氧组(30例)、神经节苷脂钠组(30例)和联合用药组(30例)。观察3组患者治疗前后炎性指标超氧化物歧化酶(superoxide dismutase,SOD)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平以及治疗后格拉斯哥昏迷评分(Glasgow coma scale, GCS)、疗效、不良反应发生情况及清醒率。结果:联合用药组清醒率(86.7%)、GCS[(12.5±2.10)分]高于高压氧组[48.39%、(9.5±1.7)分]和神经节苷脂钠组[53.33%、(8.6±1.8)分],清醒时间短于高压氧组和神经节苷脂钠组,差异有统计学意义(n P0.05)。治疗3个月后,联合用药组恢复良好率(53.3%)高于高压氧组(26.7%)和神经节苷脂钠组(23.3%);死亡率(6.7%)低于高压氧组(40.0%)和神经节苷脂钠组(40.0%),差异有统计学意义(n P0.05);治疗1个疗程后,联合用药组IL-8、TNF-α较高压氧组和神经节苷脂钠组低,SOD较高压氧组和神经节苷脂钠组高,差异有统计学意义(n P<0.05)。n 结论:神经节苷脂钠联合高压氧对重度颅脑损伤昏迷患者早期促醒效果显著,且可改善炎性反应水平,安全性高。“,”Objective:To investigate the early wake-up effect of ganglioside sodium combined with hyperbaric oxygen on patients in coma due to severe head injury.Methods:After receiving the informed consent from their families, 90 patients in persistent coma after surgery for severe craniocerebral injury were divided into 3 groups by the random number table method: hyperbaric oxygen group (30 cases), ganglioside sodium group (30 cases), and combined medication group (30 cases). The inflammatory indexes including the levels of superoxide dismutase (SOD), interleukin 8 (IL-8), and tumor necrosis factor-α (TNF-α) before and after treatment in the three groups were observed, as well as their Glasgow coma scale (GCS) scores, efficacy, adverse reactions, and awake rate after treatment.Results:After 1 month of treatment, the awake rate (86.7%) and GCS score (12.5±2.1) of the combined medication group were higher than those of the hyperbaric oxygen group (48.39%, 9.5±1.7) and the ganglioside sodium group (53.33%, 8.6±1.8), while its awake time was shorter than those of the hyperbaric oxygen group and the ganglioside sodium group, and the differences were statistically significant (n P0.05). After three months of treatment, the recovery rate (53.33%) of the combined medication group was higher than those of the hyperbaric oxygen group (26.67%) and the ganglioside group(23.33%), and its mortality (6.67%) was lower than those of the hyperbaric oxygen group (40.00%) and the ganglioside sodium group (40.00%), and the differences were statistically significant (n P0.05). After one course of treatment, the levels of IL-8 and TNF-α in the combined medication group were lower than those in the hyperbaric oxygen group and ganglioside sodium group, while its SOD was higher than those in the hypoxic group and the ganglioside sodium group, and the differences were statistically significant (n P<0.05).n Conclusion:Ganglioside sodium combined with hyperbaric oxygen has a significant early wake-up effect on patients in coma due to severe craniocerebral injury. It can reduce the inflammatory response level and has a high safety.
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