化瘀通腑法对重度颅脑损伤患者术后脑代谢及脑灌注影响.docVIP

化瘀通腑法对重度颅脑损伤患者术后脑代谢及脑灌注影响 　　[摘要] 目的 观察化瘀通腑法对重度颅脑损伤患者术后症状、脑代谢及脑灌注的影响。 方法 将80例重度颅脑损伤术后患者随机分为对照组和治疗组，对照组予常规治疗，治疗组在对照组的基础上加用化瘀通腑中药，对两组患者的症状、脑代谢和脑灌注进行比较。 结果 与对照组比较，治疗组在用药后第2周有更低的颈内静脉-动脉乳酸差，更高的格拉斯哥昏迷指数、脑氧摄取率和脑灌注压，差异有统计学意义（P0.05）。 结论 化瘀通腑法能一定程度上改善重度颅脑损伤患者术后的症状、脑代谢和脑灌注等。 　　[关键词] 化瘀通腑法；脑损伤；脑代谢；脑灌注 　　[中图分类号] R269 [文献标识码] B [文章编号] 1673-9701（2017）03-0110-03 　　Effect of Huayu Tongfu method on cerebral metabolism and cerebral perfusion after severe craniocerebral injury 　　XIE Youxin WU Lijun 　　Department of ICU， Quzhou Hospital of Traditional Chinese Medicine in Zhejiang Province， Quzhou 324002， China 　　[Abstract] Objective To observe the effect of Huayu Tongfu method on postoperative symptoms， brain metabolism and cerebral perfusion in patients with severe craniocerebral injury. Methods A total of 80 cases of severe craniocerebral injury patients were randomly divided into control group and treatment group. The control group was treated with conventional treatment， and the treatment group was given the traditional Chinese medicine with Huayu Tongfu method on the basis of the conventional treatment in the control group. The symptoms， brain metabolism and brain perfusion between the two groups were compared. Results Compared with the control group， the treatment group had lower internal jugular vein-artery lactic acid difference， and higher Glasgow coma index， cerebral oxygen uptake rate and cerebral perfusion pressure in the second week after treatment， and the difference was statistically significant（P0.05）. Conclusion Huayu Tongfu method can improve the symptoms of severe craniocerebral surgery patients， brain metabolism and brain perfusion to a certain extent. 　　[Key words] Huayu Tongfu method； Craniocerebral injury； Cerebral metabolism； Cerebral perfusion 　　重度颅脑损伤（severe traumatic brain injury，STBI）是由各种原因导致的头部外伤，以“意识障碍、头痛呕吐、血压增高”等高颅内压为主要表现，其主要治疗方式为清除血肿、降低颅内压、防止继发性脑损伤。而多年的临床经验发现运用中医“化瘀通腑法”一定程度上能改善重度颅脑损伤术后患者的脑代谢、脑灌注和?Y状等。为此，将我科2014年1月～2016年6月收入的80例重度颅脑损伤术后患者随机分为对照组和治疗