东莨菪碱在治疗重型创伤性脑损伤中临床疗效观察.docVIP

东莨菪碱在治疗重型创伤性脑损伤中临床疗效观察[摘要] 目的：观察东莨菪碱治疗重型创伤性脑损伤的临床疗效，探讨提高重型创伤性脑损伤临床疗效的治疗方法。方法：选择确诊为重型创伤性脑损伤患者87例，随机分为对照组与观察组，对照组42例采用常规外科治疗，观察组45例在常规外科治疗的基础上加用东莨菪碱治疗，比较两组患者治疗后动脉血氧分压（PaO2）、氧合指数（PaO2/FiO2）及术后6个月的临床疗效。结果：观察组临床疗效好于对照组，在治疗后动脉血氧分压（PaO2）、氧合指数（PaO2/FiO2）及术后6个月的临床疗效方面比较，差异有统计学意义（P＜0.05） 。结论：对重型创伤性脑损伤患者加用东莨菪碱治疗，可明显提高临床治疗效果，值得临床广泛推广。 [关键词] 东莨菪碱；重型；颅脑损伤 [中图分类号] R651.1+5 [文献标识码]B [文章编号]1674-4721（2010）11（a）-047-02 Clinical effects observation of scopolamine in treatment of severe traumatic brain injury MA Banyou, ZHOU Jiye, WANG Shouhai, GE Yongxing, HE Guizhi, YIN Xiaohong, (Department of Neurosurgery, Changzhou Tumor Hospital Affiliated to Medical School of Soochow University, Jiangsu Province, Changzhou 213001, China) [Abstract] Objective: To observe the clinical effects of Scopolamine in treatment of severe traumatic brain injury. Methods: Collected 87 patients with severe traumatic brain injury, they were randomly divided into control group and observer group,42 patients were divided into control group with general surgery treatment,45 patients were divided into observer group with general surgery and Scopolamine treatment, then compare PaO2, PaO2/FiO2 and the clinical effect after 6 months. Results: The observer group′s clinical effects was better than the control group′s,there was a statistical significance(P＜0.05) in PaO2, PaO2/FiO2 and the clinical effect after 6 months. Conclusion: Patients with severe traumatic brain injury are treated with scopolamine； it can increase the clinical effects obviously and should be widely promoted. [Key words] Scopolamine； Severe； Head injury 创伤性脑损伤（traumatic brain injury ，TBI）是神经外科最常见的疾病，重型创伤性脑损伤的死亡率及致残率极高。重型创伤性颅脑损伤，占急性颅脑损伤的13%~21%，自CT、MRI应用以来其诊断有了明显的提高，但病死率仍然很高，达26%~50%[1]。重型颅脑创伤患者系指GCS评分≤8分的危重症患者，其临床特点为病情严重、发展速度快、预后差[2]。因此，尽早给予重型颅脑损伤患者积极有效的治疗，对减少死亡率、改善患者预后，具有重要的临床意义。作者选择重型创伤性脑损伤（TBI）颅脑损伤患者，在临床治疗过程中加用东莨菪碱，取得了满意的临床效果，现报道如下： 1 资料与方法 1.1 一般资料 选择本科2007年1月～2009年6月，住院治疗的重型创伤性脑损伤患者87例，以上患者诊断均符合重型颅脑损伤诊断标准[3]，颅脑