切换至 "中华医学电子期刊资源库"

中华神经创伤外科电子杂志 ›› 2021, Vol. 07 ›› Issue (05) : 301 -304. doi: 10.3877/cma.j.issn.2095-9141.2021.05.010

短篇论著

高压氧联合纳美芬对弥漫性轴索损伤的临床应用效果
王学建1,(), 汪志峰1, 李峰2   
  1. 1. 226001 江苏南通,南通大学第二附属医院神经外科
    2. 226001 江苏南通,南通大学第二附属医院急诊科
  • 收稿日期:2020-11-12 出版日期:2021-10-15
  • 通信作者: 王学建
  • 基金资助:
    南通市科技项目(JC2018101); 江苏省中医药科技项目(YB2015113); 南通市医学重点人才基金项目(重点03); 南通市科技项目(HS12018002); 南通市卫生与计划生育委员会科研项目(MA2019003)

Clinical application effect of hyperbaric oxygen combined with nalmefene on diffuse axonal injury

Xuejian Wang1,(), Zhifeng Wang1, Feng Li2   

  1. 1. Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, Nantong 226001, China
    2. Department of Emergency Ward, Affiliated Hospital 2 of Nantong University, Nantong 226001, China
  • Received:2020-11-12 Published:2021-10-15
  • Corresponding author: Xuejian Wang
引用本文:

王学建, 汪志峰, 李峰. 高压氧联合纳美芬对弥漫性轴索损伤的临床应用效果[J/OL]. 中华神经创伤外科电子杂志, 2021, 07(05): 301-304.

Xuejian Wang, Zhifeng Wang, Feng Li. Clinical application effect of hyperbaric oxygen combined with nalmefene on diffuse axonal injury[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(05): 301-304.

目的

探讨高压氧(HBO)联合纳美芬对弥漫性轴索损伤(DAI)患者促醒治疗的临床效果。

方法

选取南通大学第二附属医院神经外科和急诊科自2012年8月至2019年8月收治的160例DAI患者,按照随机数字表法将患者分为常规治疗组、HBO治疗组、纳美芬治疗组和HBO联合纳美芬治疗组,各40例。随访3个月,采用GOS评分评定治疗效果,比较4组患者的预后良好率。

结果

HBO联合纳美芬治疗组的预后良好率较常规治疗组有所提高,差异有统计学意义(P<0.05)。

结论

HBO联合纳美芬对DAI昏迷患者能促进意识恢复,加速苏醒,改善生活状态。

Objective

To study the clinical application effect of hyperbaric oxygen (HBO) combined with nalmefene on wake-promoting therapy in patients with diffuse axonal injury (DAI).

Methods

A total of 160 patients with DAI admitted to the Neurosurgery and Emergency Department of Affiliated Hospital 2 of Nantong University from August 2012 to August 2019 were randomly divided into routine treatment group, HBO treatment group, nalmefene treatment group and HBO combined with nalmefene treatment group, with 40 cases in each group. The patients were followed up for 3 months. The treatment effect was evaluated by GOS score, and the good prognosis rate of 4 groups was compared.

Results

The good prognosis rate of HBO combined with nalmefene treatment group was higher than in routine treatment group, the difference was statistically significant (P<0.05).

Conclusion

HBO combined with nalmefene could promote the recovery of consciousness, accelerate waking up and improve their living condition of the patients with a DAI coma.

表1 4组患者3个月后的预后比较
[1]
Mu J, Wang T, Li M, et al. Ketogenic diet protects myelin and axons in diffuse axonal injury[J]. Nutr Neurosci, 2021, 24: 1-14. Online ahead of print.
[2]
吴树靖,孝金萍,孙艳,等.高压氧联合复方麝香注射液对弥漫性轴索损伤的临床应用[J].中华航海医学与高气压医学杂志, 2016, 23(2): 104-106.
[3]
张有友,刘良,任亮.弥漫性轴索损伤病理改变及病理生理机制的研究进展[J].中西医结合心脑血管病杂志, 2021, 19(1): 73-76.
[4]
周秀梅.高压氧联合依达拉奉治疗急性重型颅脑损伤昏迷的促醒效果观察[J].中华航海医学与高气压医学杂志, 2008, 15(3): 187-188.
[5]
赵继宗,陆峥.提高弥漫性轴索损伤的临床诊治水平[J].中华创伤杂志, 2000, 16(10): 583-584.
[6]
崔益秋,刘中平,姜素兰,等.高压氧联合神经节苷脂治疗弥漫性轴索损伤的疗效及其对血清相关指标和预后的影响[J].中华航海医学与高气压医学杂志, 2019, 26(5): 423-426.
[7]
Windisch KA, Morochnik M, Reed B, et al. Nalmefene, a mu opioid receptor antagonist/kappa opioid receptor partial agonist, potentiates cocaine motivation but not intake with extended access self-administration in adult male mice[J]. Neuropharmacology, 2021, 192: 108590.
[8]
刘春丽,李曼,王娜. SBI对老年颅脑损伤患者血清MMP-9、S100β水平和脑氧代谢的影响[J].西南国防医药, 2019, 29(3): 312-315.
[9]
韩东,宋伟,夏国庆,等.纳洛酮和纳美芬与高压氧联合治疗急性重型颅脑损伤疗效观察[J].中国继续医学教育, 2016, 8(6): 170-171.
[10]
Deng Z, Chen W, Jin J, et al. The neuroprotection effect of oxygen therapy: a systematic review and meta-analysis[J]. Niger J Clin Pract, 2018, 21(4): 401-416.
[11]
Gonzales-Portillo B, Lippert T, Nguyen H, et al. Hyperbaric oxygen therapy: a new look on treating stroke and traumatic brain injury[J]. Brain Circ, 2019, 30, 5(3): 101-105.
[12]
Daly S, Thorpe M, Rockswold S, et al. Hyperbaric oxygen therapy in the treatment of acute severe traumatic brain injury: a systematic review[J]. J Neurotrauma, 2018, 35(4): 623-629.
[13]
Crawford C, Teo L, Yang E, et al. Is hyperbaric oxygen therapy effective for traumatic brain injury? A rapid evidence assessment of the literature and recommendations for the field[J]. J Head Trauma Rehabil, 2017, 32(3): E27-E37.
[14]
Xing P, Ma K, Li L, et al. The protection effect and mechanism of hyperbaric oxygen therapy in rat brain with traumatic injury[J]. Acta Cir Bras, 2018, 33(4): 341-353.
[15]
Weaver LK, Churchill S, Wilson SH, et al. A composite outcome for mild traumatic brain injury in trials of hyperbaric oxygen[J]. Undersea Hyperb Med, 2019, 46(3): 341-352.
[1] 郑爽, 张昕彤, 陈晨, 王思凡, 燕晓翔, 王长青, 胡雅娟. 神经重症患者气管插管拔除失败的风险因素分析[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(03): 211-218.
[2] 刘建勇, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植治疗Ⅳ级肝昏迷疗效及其影响因素分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 344-349.
[3] 李文臣, 李日, 韩霖, 张舒岩. 正中神经电刺激对创伤性颅脑损伤昏迷促醒作用的Meta分析[J/OL]. 中华神经创伤外科电子杂志, 2022, 08(05): 269-275.
[4] 党圆圆, 杨艺, 夏小雨, 王勇, 陈雪玲, 何江弘. 脑深部电刺激治疗脑干出血后意识障碍一例报道[J/OL]. 中华神经创伤外科电子杂志, 2022, 08(03): 188-189.
[5] 周智, 王飚, 雷军, 黄弋洋, 汤秉洪, 毛磊. 去骨瓣减压术后硬膜下积液的治疗措施分析[J/OL]. 中华神经创伤外科电子杂志, 2022, 08(01): 44-46.
[6] 戴伟川, 郭协力, 蔡文华, 郑艳菲, 朱玉燕, 陈英贤. 弥漫性轴索损伤BDNF及其Val66Met基因多态性与认知功能的相关性研究[J/OL]. 中华神经创伤外科电子杂志, 2022, 08(01): 11-17.
[7] 薛亮, 汪熙臻, 陈业煌, 张辉建, 魏梁锋, 王守森. 正中神经电刺激对NICU重型颅脑损伤昏迷促醒的临床研究[J/OL]. 中华神经创伤外科电子杂志, 2021, 07(01): 17-20.
[8] 景方坤, 李岩峰. 颅脑创伤后慢性意识障碍促醒外科治疗的现状与展望[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 129-132.
[9] 汤天津, 于炎冰, 张黎. 周围神经电刺激的临床应用与研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(01): 51-55.
[10] 胡贤瑞, 伍振国, 何竟. 高压氧治疗创伤性脑损伤患者认知功能障碍疗效的Meta分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(01): 21-36.
[11] 邸志娟, 李红玲. HBOT在创伤性脑损伤患者中的应用及研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2023, 13(06): 373-378.
[12] 祝梅杰, 梁育磊, 梅厚东, 刘克万, 武孝刚. 早期高压氧治疗外伤性脑梗死的临床疗效及安全性分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 97-101.
[13] 帅宁安, 马悦, 强玉婷, 史晓岚, 佟莉, 董炜菁. 高压氧联合中医定向透药治疗老年糖尿病周围神经病变疗效分析[J/OL]. 中华老年病研究电子杂志, 2022, 09(03): 29-32.
[14] 田桦, 丁芳, 黄晓莉, 张丽君. 脑蛋白水解物对痉挛型脑瘫患儿肌肉痉挛评分、脑血流量及血清IGF-1、MBP、IL-6的影响[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(01): 49-54.
[15] 王国军, 王宏. 脑血疏口服液联合早期高压氧对幕上脑出血患者的治疗效果[J/OL]. 中华脑血管病杂志(电子版), 2021, 15(06): 404-406.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?