盐酸纳洛酮结合正中神经电刺激治疗脑出血昏迷的临床疗效分析

朱灼坤 孟兵 王振宁

【摘要】 目的：探討分析盐酸纳洛酮结合正中神经电刺激治疗脑出血昏迷的临床疗效。方法：选取2016年11月-2018年5月于本院收治的自发性脑出血昏迷患者72例作为研究对象，按随机数表法分为研究组和对照组，每组各36例。对照组患者给予常规治疗，研究组患者在对照组基础上，给予盐酸纳洛酮结合正中神经电刺激治疗，对比两组患者的疗效、治疗前后GCS评分及脑血肿量情况、意识觉醒恢复时间、治疗半年后日常生活能力（ADL）评分。结果：研究组总有效率明显高于对照组（P<0.05）;两组患者治疗后GCS评分较治疗前明显升高，脑血肿量明显减少（P<0.05）;且研究组患者GCS评分显著高于对照组，脑血肿量进一步少于对照组（P<0.05）;研究组患者意识觉醒恢复时间短于对照组，治疗半年后ADL评分高于对照组（P<0.05）。结论：盐酸纳洛酮结合正中神经电刺激能够有效治疗脑出血昏迷患者，降低脑血肿量，缩短意识觉醒恢复所需时间，促进患者日常生活能力的恢复，疗效显著，值得临床推广及应用。

【关键词】 盐酸纳洛酮; 正中神经电刺激; 脑出血; 昏迷

【Abstract】 Objective：To investigate and analyze the clinical effect of naloxone hydrochloride combined with median nerve electrical stimulation in the treatment of cerebral hemorrhage coma.Method：72 cases of spontaneous intracerebral hemorrhage coma treated in our hospital from November 2016 to May 2018 were selected as the research objects，they were divided into study group and control group according to random table method.Among them，36 cases in each group.The patients in the control group were given routine treatment.On this basis，the study group was given naloxone hydrochloride combined with median nerve electrical stimulation.The effective rate，GCS score before and after treatment，amount of brain hematoma，recovery time of consciousness awakening，and the daily living ability（ADL）score after six months of treatment of two groups were compared.Result：The total effective rate of the study group was significantly higher than that in the control group（P<0.05）.The GCS score increased significantly after treatment in the two groups，the amount of cerebral hematoma decreased significantly（P<0.05）;the GCS score in the study group was higher than that in the control group，the amount of cerebral hematoma was further lower than that in the control group（P<0.05）.The ADL score was higher than that of the control group after six months of treatment（P<0.05）.Conclusion：Naloxone Hydrochloride combined with median nerve electrical stimulation can effectively treat patients with cerebral hemorrhage coma，effectively promote the increase of reduce the amount of cerebral hematoma.Apart from that，it can reduce the time required for the recovery of consciousness awakening and promote the recovery of patients daily life.Therefore，its curative effect is significant，which is worthy of clinical promotion and application.

【Key words】 Naloxone Hydrochloride; Median nerve electrical stimulation; Cerebral hemorrhage; Coma

First-authors address：Dongguan Peoples Hospital，Dongguan 523000，China

doi：10.3969/j.issn.1674-4985.2019.16.038

腦出血在临床中占所有脑卒中的1/5～1/3，病死率及致残率居高不下[1]。其实质是非外伤导致的脑血管发生破裂引起的出血，其主要由于是高血脂、糖尿病、高血压、血管的老化、吸烟等因素导致脑血管发生病变引起的[2]。患者易发生昏迷，不利于患者进一步康复，导致患者的生活能力进一步下降[3]。故在临床中急需找到一种有效的治疗方法减少意识觉醒恢复所需时间，促进患者日常生活能力的恢复。本文主要研究分析盐酸纳洛酮结合正中神经电刺激治疗脑出血昏迷的临床疗效，取得了较好的效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年11月-2018年5月本院收治的自发性脑出血昏迷患者72例作为研究对象，（1）纳入标准：①3分≤格拉斯哥昏迷评分（GCS）≤8分;②颅内已无活动性出血。（2）排除标准：①患有其他严重疾病;②因其他因素导致的脑出血昏迷。……