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目的 探讨鼠神经生长因子联合奥拉西坦治疗重型急性颅脑损伤的临床疗效.方法 选择2011 年1 月-2014 年12月濮阳市油田总医院收治的重型急性颅脑损伤患者90 例,随机分为对照组和治疗组,每组各45 例.对照组静脉滴注注射用奥拉西坦,将4.0 g 注射用奥拉西坦加入250 mL 生理盐水中,1 次/d.治疗组在对照组基础上im 注射用鼠神经生长因子,用2 mL 生理盐水溶解30 μg,1 次/d.两组均连续治疗14 d.观察两组的临床疗效,同时比较两组美国国立卫生院神经功能缺损(NIHSS)评分、格拉斯哥昏迷(GCS)评分及Glasgow(GOS)评分分级情况.结果 治疗后,对照组和治疗组总有效率分别为66.67%、88.89%,两组比较差异具有统计学意义(P< 0.05).治疗第3、7、14 天两组NIHSS 评分均较治疗前显著降低,GCS 评分显著升高,同组治疗前后差异有统计学意义(P< 0.05);治疗第7、14 天治疗组NIHSS 和GCS 评分的改善程度优于对照组,两组比较差异有统计学意义(P< 0.05).对照组和治疗组的良好率分别为31.11%、46.67%,清醒率分别为53.33%、71.11%,两组良好率和清醒率比较差异均有统计学意义(P< 0.05).结论 鼠神经生长因子联合奥拉西坦治疗重型急性颅脑损伤具有较好的临床疗效,能够促进患者清醒,改善预后,具有一定的临床推广应用价值.
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[Abstract]
Objective To investigate the clinical efficacy of mouse nerve growth factor combined with oxiracetam in treatment of acute severe craniocerebral injury. Methods Patients (90 cases) with acute severe craniocerebral injury in Puyang Oilfield General Hospital from January 2011 to December 2014 were randomly divided into control and treatment groups. Each group had 45 cases. Patients in control group were iv administered with Oxiracetam for injection (4.0 g Oxiracetam for injection added 250 mL physiological saline), once daily. Patients in treatment group were im administered with Mouse Nerve Growth Factor for injection (30 μg Mouse Nerve Growth Factor for injection dissolved in physiological saline 2 mL), once daily. Patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, and NIHSS score, GCS score, and GOS classification in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 66.67% and 88.89%, respectively, and there were differences between two groups (P < 0.05). NIHSS scores in two groups were significantly reduced on days 3, 7, and 14 of the treatment, and GCS scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). NIHSS and GCS scores in the treatment group improved better than those in the control group on days 7 and 14 of the treatment, with significant differences between two groups (P < 0.05). The good rates in the control and treatment groups were 31.11% and 46.67%, respectively, while awake rate in two groups were 53.33% and 71.11%, and there were differences between two groups (P < 0.05). Conclusion Mouse nerve growth factor combined with oxiracetam has good effect in treatment of acute severe craniocerebral injury, and can promote patients awake, and also can improve prognosis, which has a certain clinical application value.
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