目的 探讨醒脑静注射液联合吡拉西坦注射液治疗脑挫裂伤的临床疗效。方法 选取2020年1月—2021年11月天津市宁河区医院收治的94例脑挫裂伤患者，根据随机数字表法将所有患者分为对照组和治疗组，每组各47例。对照组静脉滴注吡拉西坦注射液，40 mL加入250 mL生理盐水，1次/d。治疗组在对照组治疗的基础上静脉滴注醒脑静注射液，20 mL加入250 mL葡萄糖注射液充分稀释，1次/d。两组患者连续治疗2周。观察两组的临床疗效，比较两组患者的清醒时间、住院时间、神经缺损程度和昏迷程度以及血清中白细胞介素-8（IL-8）、血管内皮生长因子（VEGF）、神经元特异性烯醇化酶（NSE）的水平。结果 治疗后，治疗组的总有效率（95.74%）高于对照组（82.98%），组间比较差异显著（P<0.05）。治疗后，治疗组的清醒时间、住院时间明显短于对照组（P<0.05）。治疗后，两组美国国立卫生研究院卒中量表（NIHSS）评分低于治疗前，格拉斯哥昏迷量表（GCS）评分高于治疗前（P<0.05）；治疗后，治疗组的NIHSS评分低于对照组，GCS评分高于对照组（P<0.05）。治疗后，两组的血清IL-8、VEGF、NSE水平低于治疗前（P<0.05），且治疗组血清IL-8、VEGF、NSE水平较对照组更低，差异有统计学意义（P<0.05）。结论 醒脑静注射液联合吡拉西坦注射液治疗脑挫裂伤的疗效确切，能改善昏迷程度和降低神经功能缺损，安全性良好。

Objective To investigate the clinical efficacy of Xingnaojing Injection combined with Piracetam Injection in treatment of brain contusion and laceration. Methods Patients (94 cases) with brain contusion and laceration in Tianjin Ninghe Hospital from January 2020 to November 2021 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were po administered with Piracetam Injection, 40 mL added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Xingnaojing Injection on the basis of the control group, 20 mL added into glucose injection 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and the awake time, the hospital stay, the degree of nerve defect, the degree of coma, the serum levels of IL-8, VEGF, and NSE in two group were compared. Results After treatment, the total effective rate of the treatment group (95.74%) was higher than that of the control group (82.98%), and there was significant reference between two groups (P < 0.05). After treatment, the awake time and hospital stay in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the NIHSS score of two groups was lower than that before treatment, but the GCS score of two groups was higher than that before treatment (P < 0.05). After treatment, the NIHSS score of the treatment group was lower than that of the control group, but the GCS score of the treatment group was higher than that of the control group (P < 0.05). After treatment, the serum levels of IL-8, VEGF, and NSE in two groups were lower than those before treatment (P < 0.05), and the serum levels of IL-8, VEGF, and NSE in the treatment group were lower than those in the control group (P< 0.05). Conclusion Xingnaojing Injection combined with Piracetam Injection has curative effect in treatment of brain contusion and laceration, can improve the degree of coma, and reduce neurological deficit, with good safety.

R971

河北省医学科学研究课题计划项目（20200293）