颅脑外伤应用糖皮质激素治疗效果观察.docVIP

颅脑外伤应用糖皮质激素治疗效果观察 　　[摘要] 目的 探究在颅脑外伤的临床治疗中糖皮质激素的应用效果。方法 整群选取2012年4月―2014年12月在该院治疗的颅脑外伤患者86例，按照随机分组原则将其分为对照组和糖皮质激素治疗组分别为43例，对照组患者采取常规的对症缓解治疗，治疗组患者则在对症治疗的基础上采用糖皮质激素进行治疗，比较两组患者治疗7 d后脑组织动态变化、患者血糖以及消化道的出血状况。 结果 两组患者在治疗7 d后均未出现消化道出血症状，而治疗组患者的脑水肿消退率95.3%和好转情况明显高于对照组69.8%，同时治疗组患者的血糖增高率34.9%情况明显高于对照组18.6%，其差异具有统计学意义（P0.05）。 结论 在颅脑外伤的临床治疗中应用糖皮质激素能够显著改善患者的脑水肿状况，但患者的血糖水平有一定的上升，因此在患者的临床应用治疗中糖皮质激素要酌情使用。 　　[关键词] 颅脑外伤； 糖皮质激素； 脑水肿；血糖水平 　　[中图分类号] R7 [文献标识码] A [文章编号] 1674-0742（2015）08（b）-0096-02 　　[Abstract] Objective To explore the clinical application effect of glucocorticoid in the treatment of craniocerebral trauma. Methods 86 cases with craniocerebral trauma were selected which were treated in our hospital during April 2012 to December 2014， and randomly assigned for control group and glucocorticoid treatment group， 43 cases in each group. The control group was treated by conventional symptomatic relief， the treatment group was treated by glucocorticoid on the basis of symptomatic treatment， Dynamic changes of brain tissue， blood glucose and the bleeding of digestive tract were compared after 7 days. Results 7 days after treatment， both groups not had the symptoms of gastrointestinal bleeding. In treatment group， the regression rate of encephaledema （95.3%） and the improvement rate were significantly higher than the control group （69.8%）. The increase rate of blood glucose was 34.9% and was significantly higher than the control group of 18.6%， the difference was statistical significance （P ？ 0.05）. Conclusion In the clinical treatment of craniocerebral trauma， glucocorticoid can significantly improve the patients brain edema condition， but the blood glucose level of patients had a certain rise. Therefore， glucocorticoid should be appropriate to use in the clinical application of treatment. 　　[Key words] Craniocerebral trauma； Glucocorticoids； Brain edema； Blood glucose levels 　　糖皮质激素在颅脑外伤的临床应用已经有很多临床报道，但是其临床应用一直存在争议，首先是糖皮质激素能够对血管通透性起作用，因此对患者的脑水肿症状有显著的改善作用，同时能够减少炎性递质的形成[1]，使