CAJ | 학술논문

目的观察联合使用亚低温及大剂量硫酸镁治疗弥漫性轴索损伤的临床效果.方法64例诊断为弥漫性轴索损伤,GCS评分为3～8的患者被随机分为治疗组和对照组.治疗组的患者入院20 min后给予静注24 mmol硫酸镁,再用80 mmol持续24 h静滴,同时自伤后6 h开始联合用亚低温治疗,使直肠温度控制在33～35 ℃,治疗时间为3～5 d,对照组按普通常规治疗.两组患者均于入院当天、治疗后3d和7d测血清神经元特异性异烯醇化酶(NSE)和GCS,出院和3个月后测GOS.结果治疗组和对照组的血清NSE,GCS 和GOS分别为(24.8±19.2)g/L,12.3±3.3,4.6±1.3和(49.7±23.1)g/L,9.8±2.8,3.0±1.5,两组差异有显著性(P＜0.01).结论联合使用亚低温和大剂量硫酸镁治疗弥漫性轴索损伤有明显疗效.
목적관찰연합사용아저온급대제량류산미치료미만성축색손상적림상효과.방법64례진단위미만성축색손상,GCS평분위3～8적환자피수궤분위치료조화대조조.치료조적환자입원20 min후급여정주24 mmol류산미,재용80 mmol지속24 h정적,동시자상후6 h개시연합용아저온치료,사직장온도공제재33～35 ℃,치료시간위3～5 d,대조조안보통상규치료.량조환자균우입원당천、치료후3d화7d측혈청신경원특이성이희순화매(NSE)화GCS,출원화3개월후측GOS.결과 치료조화대조조적혈청NSE,GCS 화GOS분별위(24.8±19.2)g/L,12.3±3.3,4.6±1.3화(49.7±23.1)g/L,9.8±2.8,3.0±1.5,량조차이유현저성(P＜0.01).결론 연합사용아저온화대제량류산미치료미만성축색손상유명현료효.
Objective To observe the clinical effects of combined mild hypothermia and high dose of magnesium sulfate (MHMS) in treatment of diffuse axonal injury (DAI).Methods 64 patients suffered from DAI and had Glasgow Coma Scale (GCS) scores of 3 to 8.They were randomly divided into two groups: MHMS treatment group (n=32) and control group (n=32).MHMS treatment group: mild hypothermia was used to keep the rectal temperature at 33 to 35℃ and received 24 mmol magnesium sulfate intravenously at 20 minutes after admission,followed by 80 mmol magnesium sulfate intravenously everyday for 3 to 5 days.Control group: patients were only treated with common method without MHMS.Serum neuron specific enolase (NSE),GCS and GOS of all the patients were measured.GCS score was recorded at admission,at 3 days,7 days,and 2 weeks;serum NSE values was measured at admission,at 3 days and 7 days.Outcome was determined by Glasgow Outcome Scale (GOS) score at discharge and after 3 months.The data were analyzed statistically.Results The serum NSE,GCS and GOS in the MHMS group were (24.8±19.2)g/L,12.3±3.3 and 4.6±1.3,respectively;while in control group were (49.7±23.1) g/L,9.8±2.8 and 3.0±1.5,respectively.There was significant difference between the two groups in serum NSE,GCS and GOS (P＜0.01).Conclusion Mild hypothermia combined with high dose of magnesium sulfate therapy is effective in the treatment of patients with DAI.