醒脑静与盐酸纳洛酮治疗昏迷脑出血的临床观察
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篇名: 醒脑静与盐酸纳洛酮治疗昏迷脑出血的临床观察
TITLE:
摘要: 目的:观察醒脑静与盐酸纳洛酮治疗昏迷脑出血的疗效及安全性。方法:将126例昏迷脑出血患者按随机数字表法分为醒脑静组和盐酸纳洛酮组,各63例。两组患者均根据身体情况采用20%甘露醇和/或地塞米松静脉滴注进行脱水治疗,并进行其他基础治疗。醒脑静组患者给予醒脑静注射液20 ml加入5%葡萄糖注射液250 ml,ivgtt,qd;盐酸纳洛酮组患者给予盐酸纳洛酮注射液4 mg加入5%葡萄糖注射液250 ml,ivgtt,qd。观察两组患者的临床疗效、住院时间、出院前后神经功能缺损(NIHSS)评分、治疗前后格拉斯哥昏迷(GCS)评分和脑血肿量,并记录不良反应情况。结果:盐酸纳洛酮组患者临床总有效率为88.89%,显著高于醒脑静组的74.61%,差异有统计学意义(P<0.05);盐酸纳洛酮组患者的平均住院时间为(17.5±8.8)d,显著低于醒脑静组的(28.4±10.3)d,差异有统计学意义(P<0.05)。两组患者出院前、出院后3个月的NIHSS评分显著低于入院前,且出院后3个月盐酸纳洛酮组患者的NIHSS评分显著低于醒脑静组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后两组患者的GCS评分显著升高,脑血肿量显著降低,且盐酸纳洛酮组明显优于醒脑静组,差异有统计学意义(P<0.05)。两组患者均未见明显不良反应。结论:盐酸纳洛酮较醒脑静能明显促进昏迷脑出血患者神经功能恢复,提高临床疗效,且安全性较好。
ABSTRACT: OBJECTIVE: To observe therapeutic efficacy and safety of Xingnaojing and naloxone hydrochloride in the treatment of coma patients with cerebral hemorrhage. METHODS: 126 coma patients with cerebral hemorrhage were randomly assigned into Xingnaojing group and naloxone hydrochloride group with 63 cases in each group. Both groups were given 20% mannitol or and dexamethasone intravenously for dehydration therapy and other basic treatment. Xingnaojing group was given Xingnaojing injection 20 ml added into 5% Glucose injection 250 ml, ivgtt, qd; naloxone hydrochloride group was given Naloxone hydrochloride injection 4 mg added into 5% Glucose injection 250 ml, ivgtt, qd. Clinical efficacy, length of stay, NIHSS before and after discharge, GCS and cerebral hematoma volume before and after treatment were observed in 2 groups, and ADR was recorded. RESULTS: The total effective rate of observation group was 88.89%, which was significantly higher than that of control group (74.61%), with statistical significance (P<0.05); average length of stay in observation group was (17.5±8.8)d, which was significantly lower than (28.4±10.3)d of control group, with statistical significance (P<0.05). NIHSS of patients before discharge and 3 months after discharge were significantly lower than before admission, and the naloxone hydrochloride group was lower than the Xinnaojing group, with statistical significance (P<0.05). After treatment, GCS were increased significantly and cerebral hematoma volume of 2 groups were significantly lower before treatment, and the naloxone hydrochloride group was lower than the Xingnaojing group, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS: Naloxone hydrochloride is better than Xingnaojing in improving neurological recovery and clinical efficacy, and shows good safety.
期刊: 2016年第27卷第11期
作者: 王晟,毛新龙,邹军辉
AUTHORS: WANG Sheng,MAO Xinlong,ZOU Junhui
关键字: 醒脑静;盐酸纳洛酮;昏迷脑出血;临床疗效
KEYWORDS: Xingnaojing; Naloxone hydrochloride; Coma cerebral hemorrhage; Clinical efficacy
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