【摘要】 目的 :通过定量脑电图监测 ,探讨不同剂量的纳洛酮对急性脑伤患者不同伤情的疗效。方法 :选择受伤后 12h内入院的急性脑损伤患者 86例 ,按伤情轻重分为GCS3～ 5分、GCS6～ 8分、GCS9～ 12分 3组。每组再分为纳洛酮治疗组和对照组。纳洛酮治疗组又分为小剂量组及大剂量组。用定量脑电图监测 ,观察用药前、用药后 30min、1h、2h、2 4h、4 8h、72h、12 0hδ频段相对功率值及总功率值的变化。结果 :GCS9～ 12分 ,纳洛酮治疗组用药 1h后定量脑电图两个指标较对照组有显著性差异 ,大小剂量间无差异 ;GCS6～ 8分 ,大小剂量组用药 1h后脑电指标与对照组之间、大小剂量之间均有显著性差异。对GCS3～ 5分组 ,纳洛酮治疗组与对照组之间上述两项指标无显著性差异。结论 :本文选用的小剂量与大剂量纳洛酮对中型脑伤有治疗作用 ,但两种剂量的疗效无差异 :对GCS6～ 8分重型脑伤 ,上述两种剂量虽都有疗效 ,但大剂量组疗效更显著。更多还原

【Abstract】 Objective:To reveal the effects of different doses of naloxone on moderate and severe acute head injuries by monitoring of qEEG.Methods:86 patients with moderate and severe acute head injuries (Glasgow Coma Scale 3～12,within 12 hours after injury) were selected for this study.According to the severity of injury,all patients were classified into three groups: GCS3～5,GCS6～8 and GCS9～12.Patients of each group were then randomly assigned to treatment with naloxone or control.In naloxone groups,low doses of naloxone and high doses of naloxone were administered respectively to the patients with acute brain injury of different severity for three days.Relative power of δ frequency and absolute power of 1～25 frequency were monitored with qEEG before and 30 minutes,1,2,24,48,72,120 hours after administration.Results:In GCS 9 to 12 group,relative power of δ frequency and absolute power of 1～25 frequency were significanfly different ( P <0.05) in qEEG between naloxone groups and control group,while there was no significant difference of all parameters between low dose and high dose naloxone groups( P >0.05).In GCS 6 to 8 group,the two parameters were improved significanfly in naloxone groups and were significantly different between low dose and high dose naloxone groups.In GCS 3 to 5 group,all parameters were not significantly different between naloxone group and control group.Conclusion:These results suggest that treatment with naloxone in patients with moderate and severe head injuries is beneficial in terms of improved qEEG and there is no significant difference between low dose and high dose naloxone in GCS 9 to 12 group,but in GCS 6 to 8 group high dose naloxone shows better efficacy than low dose naloxone.更多还原