| 摘要: |
| 目的:观察盐酸纳美芬在重度颅脑损伤手术儿童脑保护中的临床效果。方法:以2016年1月至2017年3月我院收治的61例重度颅脑损伤手术患儿为研究对象,按是否应用盐酸纳美芬治疗分为观察组34例和对照组27例,比较两组儿童术后1d、3d、5d、7d各个时间点总动脉血流速度、血清神经功能(强啡肽、内啡肽、神经元特异性烯醇化酶)、血清炎性因子(IL-4、IL-6、IL-10、TNF-α)指标差异,并分析两组儿童治疗预后及不良反应。结果:两组儿童血清强啡肽、内啡肽、神经元特异性烯醇化酶在3d、5d、7d依次降低,但观察组儿童降低幅度更大,差异有统计学意义(P<0.05)。两组儿童颈总动脉血流速度在3d、5d、7d依次提升,但观察组儿童提升幅度更大,差异有统计学意义(P<0.05)。两组儿童术前1天血清IL-6、TNF-α、IL-4、IL-10比较差异无统计学意义(P>0.05)。两组儿童血清致炎因子IL-6、TNF-α水平在术后3d、5d、7d依次降低,但观察组儿童降低幅度更大,差异有统计学意义(P<0.05)。两组儿童血清抗炎因子IL-4、IL-10在术后3d、5d、7d依次提升,但观察组儿童提升幅度更大,差异有统计学意义(P<0.05)。结论:术后应用盐酸纳美芬可有效改善重度颅脑损伤手术儿童颈总动脉血流、减轻血清神经功能相关指标强啡肽、内啡肽、神经元特异性烯醇化酶对颅脑损伤的继发性病理损伤,降低致炎因子高表达,促进抗炎因子高表达,从而对重度颅脑损伤手术儿童起到脑保护作用。 |
| 关键词: 纳美芬 重度颅脑损伤 脑保护 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.12.005 |
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| 基金项目: |
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| Cerebral Protection of Nalmefene in Children with Severe Craniocerebral Injury |
| Yang Liangmin, Xie Xiaojuan, Ma Ligang, Song Shaotuan |
| (The First Affiliated Hospital of Henan University of Science and Technology, Henan Luoyang 471000, China) |
| Abstract: |
| Objective: To observe the clinical effects of nalmefene hydrochloride in the cerebral protection of children with severe craniocerebral injury. Methods: A total of 61 children with severe craniocerebral injury admitted into our hospital from Jan. 2016 to Mar. 2017 were extracted to be divided into observation group (n=34) and control group (n=27) through whether or not with the application of nalmefene hydrochloride. The common carotid artery blood flow, serum neurological function (dynorphin, endorphin, neuron-specific enolase) and serum inflammatory factors (IL-4, IL-6, IL-10, TNF-α) indicators were compared between two groups at 1 d, 3 d, 5 d, and 7 d after surgery. And differences in treatment prognosis and adverse drug reactions between two groups were analyzed. Results: Serum dynorphin, endorphin and neuron-specific enolase decreased significantly in two groups at 3 d, 5 d, and 7 d, and the decrease was greater in observation group, with statistically significant differences (P<0.05). The common carotid artery blood flow velocity in two groups increased significantly in 3 d, 5 d, 7 d, and the increase in observation group was greater, and the difference was statistically significant (P<0.05). There was no significant difference in serum IL-6, TNF-α, IL-4 and IL-10 levels between two groups (P>0.05). The serum proinflammatory factors IL-6 and TNF-α decreased significantly in two groups at 3 d, 5 d, and 7 d after surgery, and the decrease was greater in observation group (P<0.05). The serum anti-inflammatory factors IL-4 and IL-10 increased significantly in two groups at 3 d, 5 d, and 7 d after surgery, and the increase in observation group was greater, with statistically significant difference (P<0.05). Conclusion: Nimesulone hydrochloride can effectively improve the common carotid artery blood flow, relief the serum neurological function related indicators dynorphin, endorphin, neuron specific enolase for secondary pathological injury of cerebral injury, reduce the high expression of proinflammatory factors and promote high expression of anti-inflammatory factors, so as to provide cerebral protection for children with severe craniocerebral injury. |
| Key words: nalmefene hydrochloride severe craniocerebral injury cerebral protection children |
