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目的应用前瞻性研究探讨β受体阻断剂心得安改善重型颅脑创伤患者的生存率和神经功能的治疗效果。方法选择重型颅脑创伤患者100例,随机分成对照组和治疗组各50例,治疗组给予心得安持续48 h,对照组予常规治疗。观察各时间点患者的生存率和神经功能缺失状态,同时比较血生化和血气指标等。评估心得安改善颅脑创伤患者生存率和神经功能状态,为临床推广应用提供科学依据。结果两组治疗后去甲肾上腺素、尿儿茶酚胺、氧分压及GCS评分均较治疗前改善(P<0.01),治疗组改善情况较对照组更为显著,差异有统计学意义(P<0.01)。两组治疗后神经功能状态均较前改善,治疗组较对照组改善更为明显,差异有统计学意义(P<0.01)。结论心得安治疗使重型颅脑创伤患者的生存率和神经功能状态得到改善,提高了伤者的生命质量,减轻家庭和社会负担,节约卫生资源。
Objective To investigate the effect of β-blocker propranolol on improving the survival rate and neurological function of patients with severe traumatic brain injury by prospective study. Methods 100 cases of severe traumatic brain injury were selected and randomly divided into control group and treatment group with 50 cases each. The treatment group was given propranolol for 48 hours and the control group was given routine treatment. To observe the survival rate of patients at various time points and the state of neurological deficit, while comparing blood biochemical and blood gas indicators. To assess the prognosis of patients with craniocerebral trauma to improve the survival rate and neurological status, to provide a scientific basis for clinical application. Results After treatment, norepinephrine, urinary catecholamine, partial pressure of oxygen and GCS score improved compared with those before treatment (P <0.01), and the improvement in the treatment group was more significant than that in the control group (P <0.01) ). After treatment, the neurological status of the two groups improved compared with the former, and the treatment group improved more obviously than the control group, the difference was statistically significant (P <0.01). Conclusion Andean treatment can improve the survival rate and neurological status of patients with severe traumatic brain injury, improve the quality of life of the injured, reduce the burden on families and society, and save the resources for health care.