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目的探讨醒脑静治疗重型颅脑损伤(severe traumatic brain injury,sTBI)的疗效和安全性。方法 60例sTBI患者随机分为对照组及观察组各30例,对照组给予脱水、抗感染、纠正水电解质紊乱、营养支持等常规治疗,并根据需要行标准颅脑外伤去大骨瓣开颅手术联合亚低温治疗,观察组在对照组治疗基础上给予醒脑静注射液30 mL+生理盐水250mL,1次/d,连续7d。比较2组入院时、治疗7d后血清S100B蛋白、髓鞘碱性蛋白(myelin basic protein,MBP)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平及格拉斯哥昏迷评分(Glasgow Coma Score,GCS)变化。结果观察组、对照组治疗7d后血清S100B[(0.85±0.11)、(1.17±0.21)mg/L]、MBP[(6.49±1.01)、(9.35±1.72)mg/L]和NSE[(11.16±1.81)、(18.03±1.79)mg/L]水平均较入院时[S100B(1.62±0.23)、(1.61±0.38)mg/L,MBP(15.07±2.32)、(14.51±2.20)mg/L,NSE(37.51±1.84)、(37.27±1.96)mg/L]降低(P<0.05),观察组较对照组降低明显(P<0.05);观察组治疗7d后GCS评分>12~15分比例(60.0%)高于对照组(30.0%)(P<0.05)。结论在常规治疗基础上应用醒脑静可降低sTBI患者血清S100B、MBP和NSE水平,改善患者昏迷程度。
Objective To investigate the efficacy and safety of Xingnaojing in treating severe traumatic brain injury (sTBI). Methods Sixty patients with sTBI were randomly divided into control group and observation group, with 30 cases in each group. The control group was given routine treatment such as dehydration, anti-infective, water and electrolyte disturbance, nutritional support, and standard craniocerebral trauma to large craniotomy The operation was combined with mild hypothermia. The observation group was given 30 mL xingnaojing injection and 250 mL normal saline on the basis of the control group, once a day for 7 days. The levels of serum S100B, myelin basic protein (MBP) and neuron-specific enolase (NSE), and Glasgow Coma Score , GCS) changes. Results Serum levels of S100B [(0.85 ± 0.11), (1.17 ± 0.21) mg / L], MBP [(6.49 ± 1.01), (9.35 ± 1.72) mg / L] and NSE [(11.16 ± 1.81, and (18.03 ± 1.79) mg / L] were significantly higher than those on admission [S100B (1.62 ± 0.23), (1.61 ± 0.38) mg / L, MBP (15.07 ± 2.32) and (14.51 ± 2.20) mg / , NSE (37.51 ± 1.84), (37.27 ± 1.96) mg / L] (P <0.05), and the observation group was significantly lower than the control group (P <0.05) (60.0%) was higher than the control group (30.0%) (P <0.05). Conclusion The application of Xingnaojing on the basis of routine treatment can reduce the level of S100B, MBP and NSE in patients with sTBI and improve the coma degree.