纳美芬治疗重型颅脑损伤患者临床疗效观察

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目的:比较盐酸纳美芬注射液和脑复康注射液治疗重型颅脑损伤患者的临床疗效及安全性。方法:60例重型颅脑损伤患者随机均分为观察组和对照组。两组患者均采用常规脱水、扩容、抗感染等治疗。在此基础上,观察组予盐酸纳美芬注射液0.4~0.6 mg加入0.9%氯化钠注射液250 ml,ivd,qd;对照组予脑复康注射液4~9 g加入5%或10%葡萄糖注射液250ml,ivd,qd。两组疗程均为两周。比较两组患者治疗3 d时心律、呼吸异常的发生率,颅内压状况;治疗10 d时评价两组临床综合疗效,治疗后比较两组并发症发生情况。结果:治疗3 d后,观察组心律异常、呼吸异常发生率明显低于对照组(P<0.05),颅内压情况明显优于对照组(P<0.05)。治疗10 d后综合疗效比较,观察组治疗总有效率为93.3%,明显高于对照组的66.7%(P<0.05)。治疗后,观察组中呼吸道感染、酸碱失衡及上消化道出血等并发症的发生率均明显低于对照组(P<0.05)。结论:盐酸纳美芬注射液治疗重型颅脑损伤患者疗效显著,安全性高,明显优于脑复康注射液。 Objective: To compare the clinical efficacy and safety of nalmefene hydrochloride injection and naofukang injection in patients with severe craniocerebral injury. Methods: Sixty patients with severe traumatic brain injury were randomly divided into observation group and control group. Two groups of patients are using conventional dehydration, dilatation, anti-infection treatment. On this basis, the observation group was treated with nalmefene hydrochloride injection 0.4-0.6 mg, 0.9% sodium chloride injection 250 ml, ivd, qd, and the control group was given Naofukang injection 4-9 g 5% or 10 % Glucose injection 250ml, ivd, qd. Two courses of treatment are two weeks. The heart rate, respiratory rate and intracranial pressure were compared between the two groups after 3 days of treatment. The clinical efficacy of the two groups was evaluated on the 10th day after treatment, and the complications were compared between the two groups after treatment. Results: After 3 days of treatment, the incidence of abnormal heart rate and respiratory abnormality in the observation group was significantly lower than that in the control group (P <0.05). The intracranial pressure was significantly better than that in the control group (P <0.05). After 10 days of treatment, the total effective rate in the observation group was 93.3%, which was significantly higher than that in the control group (66.7%, P <0.05). After treatment, the incidence of respiratory tract infection, acid-base imbalance and upper gastrointestinal bleeding in the observation group were significantly lower than those in the control group (P <0.05). Conclusion: Nalmefene hydrochloride injection in patients with severe craniocerebral injury has significant curative effect, high safety and is superior to Naofukang injection.
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