Analysis of drug treatment efficacy in patients with post-traumatic sympathetic hyperactivity following cranial trauma

doi:10.3877/cma.j.issn.2095-9141.2024.04.007

Abstract

Abstract:

Objective

To analyze the therapeutic effect of medication on paroxysmal sympathetic hyperactivity (PSH) after cranial trauma.

Methods

Sixty-eight patients with PSH after cranial trauma admitted to Neurosurgery Department of Xuzhou Central Hospital from January 2018 to June 2022 were selected as the research subjects. Patients were divided into control group and treatment group using a random number table method, with 34 cases in each group. Both groups of patients were given basic treatments such as oxygen therapy, appropriate control of intracranial pressure, maintenance of stable cerebral perfusion, and nutritional support. The control group received oral propranolol, while the treatment group received oral propranolol combined with dexmedetomidine infusion. The length of ICU stay and frequency of PSH attack were compared between the two groups.Changes in PSH-AM scores and levels of tumor necrosis factor α (TNF-α), serum neuron specific enolase (NSE), and central nervous system specific protein β (S100-β) were compared before and after treatment with two different regimens.

Results

The length of ICU stay and frequency of PSH attacks in the treatment group were significantly reduced compared to the control group (P＜0.05).After treatment,the PSH-AM scores of both groups were lower than before treatment, and the treatment group were lower than the control group, with statistical significance (P＜0.05). The average levels of TNF-α, NSE, and S100-β in two groups after treatment were lower than before treatment, and the treatment group were lower than the control group, with statistical significance (P＜0.05).

Conclusion

In patients with PSH after cranial trauma, the combination of propranolol and dexmedetomidine in treatment can more effectively control symptoms of sympathetic hyperactivity and alleviate neurological damage.

Key words: Cranial trauma, Paroxysmal sympathetic hyperactivity, Drug treatment, Tumor necrosis factor α, S100-β protein, Neuron specific enzyme

Changtong Tang, Yongnan Wang, Shiquan Wang. Analysis of drug treatment efficacy in patients with post-traumatic sympathetic hyperactivity following cranial trauma[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(04): 233-237.

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References 21

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组别	例数	ICU住院时长（d）	发作频次（次）
对照组	34	22（18.50，24.00）	1（1，1）
治疗组	34	14（10.00，19.25）	1（0，1）
Z值		-4.536	-4.245
P值		＜0.001	＜0.001

组别	例数	ICU住院时长（d）	发作频次（次）
对照组	34	22（18.50，24.00）	1（1，1）
治疗组	34	14（10.00，19.25）	1（0，1）
Z值		-4.536	-4.245
P值		＜0.001	＜0.001

组别	例数	治疗前	治疗后	t值	P值
对照组	34	16.44±3.15	6.68±2.72	13.678	＜0.001
治疗组	34	16.65±2.23	4.15±1.81	25.386	＜0.001
t值		-0.311	4.518
P值		0.757	＜0.001

组别	例数	治疗前	治疗后	t值	P值
对照组	34	16.44±3.15	6.68±2.72	13.678	＜0.001
治疗组	34	16.65±2.23	4.15±1.81	25.386	＜0.001
t值		-0.311	4.518
P值		0.757	＜0.001

组别	例数	TNF-α（ng/L）				NSE（g/mL）				S100-β（pg/mL）
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	34	40.16±5.48	40.61±5.55	-0.341	0.734	18.12±7.04	9.40±3.67	6.396	＜0.001	152.44±38.65	76.82±8.12	11.166	＜0.001
治疗组	34	42.33±6.34	33.96±4.65	-6.206	＜0.001	20.28±8.21	7.46±2.89	-8.585	＜0.001	148.71±55.05	64.56±3.81	8.892	＜0.001
t值		-1.510	5.362			-1.164	2.422			0.324	7.976
P值		0.136	＜0.001			0.249	0.018			0.747	＜0.001

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