{"title":"右美托咪定联合布托啡诺治疗创伤性脑损伤 (TBI) 的临床研究。","authors":"Xuejian Wang, Zhifeng Wang, Chen Sun, Zhiming Cui","doi":"10.5137/1019-5149.JTN.36585-21.2","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To explore whether the combination of dexmedetomidine (Dex) and butorphanol (But) could benefit patients with traumatic brain injury (TBI).</p><p><strong>Material and methods: </strong>A total of 208 TBI patients admitted from February 2018 to January 2020 were randomly divided into four groups as follows: control group (A), Dex group (B), But group (C), and combination of dexmedetomidine and butorphanol group (D). Four groups of patients were treated and studied clinically. Statistical analysis was performed to assess the changes in signs of life, oxygen saturation, serum neuroendocrine data, pain, and agitation scores.</p><p><strong>Results: </strong>The statistical data of signs of life and blood oxygen saturation of the four groups were compared, and the differences between group A and group D were statistically significant (p < 0.05), indicating that a combination of sedative and analgesic agents at low doses could improve the signs of life of TBI patients, and the safety was relatively good. The Glasgow Coma Scale (GCS) score of the group D on the 5th day post-surgery was improved compared with the control group (A group), suggesting that the combination of sedative and analgesic agents could improve patients' consciousness. The neuroendocrine data of the combination group showed little fluctuation, indicating that a combination of sedative and analgesic agents could significantly reduce the stress response. The scores of pain and agitation in the combination group were significantly improved on the 3rd and 5th days, suggesting that the combination group was better compared with the control group.</p><p><strong>Conclusion: </strong>The combination of Dex and But was more stable for the treatment of vital signs. Compared with the individual treatment groups, the patients in the combination group had a rapid improvement. The time from treatment to stabilization was shortened, and the prognosis was significantly better compared with the control group. A combination of Dex and But at low doses could significantly maintain neuroendocrine stability. Meanwhile, a combination of sedative and analgesic agents had obvious synergistic effects on enhancing sedation and analgesia as well as anti-muscle tension. Collectively, the combination of Dex and But could significantly benefit the prognosis of TBI.</p>","PeriodicalId":23395,"journal":{"name":"Turkish neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Study of Dexmedetomidine in Combination with Butorphanol for the Treatment of Traumatic Brain Injury (TBI).\",\"authors\":\"Xuejian Wang, Zhifeng Wang, Chen Sun, Zhiming Cui\",\"doi\":\"10.5137/1019-5149.JTN.36585-21.2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To explore whether the combination of dexmedetomidine (Dex) and butorphanol (But) could benefit patients with traumatic brain injury (TBI).</p><p><strong>Material and methods: </strong>A total of 208 TBI patients admitted from February 2018 to January 2020 were randomly divided into four groups as follows: control group (A), Dex group (B), But group (C), and combination of dexmedetomidine and butorphanol group (D). Four groups of patients were treated and studied clinically. Statistical analysis was performed to assess the changes in signs of life, oxygen saturation, serum neuroendocrine data, pain, and agitation scores.</p><p><strong>Results: </strong>The statistical data of signs of life and blood oxygen saturation of the four groups were compared, and the differences between group A and group D were statistically significant (p < 0.05), indicating that a combination of sedative and analgesic agents at low doses could improve the signs of life of TBI patients, and the safety was relatively good. The Glasgow Coma Scale (GCS) score of the group D on the 5th day post-surgery was improved compared with the control group (A group), suggesting that the combination of sedative and analgesic agents could improve patients' consciousness. The neuroendocrine data of the combination group showed little fluctuation, indicating that a combination of sedative and analgesic agents could significantly reduce the stress response. The scores of pain and agitation in the combination group were significantly improved on the 3rd and 5th days, suggesting that the combination group was better compared with the control group.</p><p><strong>Conclusion: </strong>The combination of Dex and But was more stable for the treatment of vital signs. Compared with the individual treatment groups, the patients in the combination group had a rapid improvement. The time from treatment to stabilization was shortened, and the prognosis was significantly better compared with the control group. A combination of Dex and But at low doses could significantly maintain neuroendocrine stability. Meanwhile, a combination of sedative and analgesic agents had obvious synergistic effects on enhancing sedation and analgesia as well as anti-muscle tension. Collectively, the combination of Dex and But could significantly benefit the prognosis of TBI.</p>\",\"PeriodicalId\":23395,\"journal\":{\"name\":\"Turkish neurosurgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Turkish neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5137/1019-5149.JTN.36585-21.2\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5137/1019-5149.JTN.36585-21.2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨右美托咪定(Dex)和丁羟吗啡(But)联合应用是否对创伤性脑损伤(TBI)患者有益:将2018年2月至2020年1月收治的208例创伤性脑损伤患者随机分为以下四组:对照组(A)、右美托咪定组(B)、丁啡诺组(C)、右美托咪定与丁啡诺联合组(D)。对四组患者进行治疗和临床研究。对生命体征、血氧饱和度、血清神经内分泌数据、疼痛和躁动评分的变化进行了统计分析:比较四组生命体征和血氧饱和度的统计数据,A 组和 D 组差异有统计学意义(P<0.05),说明小剂量镇静镇痛联合用药可改善创伤性脑损伤患者的生命体征,安全性相对较好。与对照组(A 组)相比,D 组患者术后第 5 天的格拉斯哥昏迷量表(GCS)评分有所改善,表明镇静镇痛联合用药可改善患者的意识。联合用药组的神经内分泌数据波动很小,表明镇静镇痛联合用药可显著减轻应激反应。联合用药组的疼痛和躁动评分在第 3 天和第 5 天有明显改善,表明联合用药组的疗效优于对照组:结论:Dex 和 But 的联合治疗对生命体征的改善更稳定。结论:联合使用地塞米松和布特治疗生命体征更稳定,与单独治疗组相比,联合治疗组患者的病情改善更快。从治疗到病情稳定的时间缩短,预后明显优于对照组。小剂量的 Dex 和 But 联合用药能明显维持神经内分泌的稳定。同时,镇静剂和镇痛剂的联合应用在增强镇静、镇痛和抗肌肉紧张方面具有明显的协同作用。总之,Dex 和 But 的联合用药对创伤性脑损伤的预后大有裨益。
Clinical Study of Dexmedetomidine in Combination with Butorphanol for the Treatment of Traumatic Brain Injury (TBI).
Aim: To explore whether the combination of dexmedetomidine (Dex) and butorphanol (But) could benefit patients with traumatic brain injury (TBI).
Material and methods: A total of 208 TBI patients admitted from February 2018 to January 2020 were randomly divided into four groups as follows: control group (A), Dex group (B), But group (C), and combination of dexmedetomidine and butorphanol group (D). Four groups of patients were treated and studied clinically. Statistical analysis was performed to assess the changes in signs of life, oxygen saturation, serum neuroendocrine data, pain, and agitation scores.
Results: The statistical data of signs of life and blood oxygen saturation of the four groups were compared, and the differences between group A and group D were statistically significant (p < 0.05), indicating that a combination of sedative and analgesic agents at low doses could improve the signs of life of TBI patients, and the safety was relatively good. The Glasgow Coma Scale (GCS) score of the group D on the 5th day post-surgery was improved compared with the control group (A group), suggesting that the combination of sedative and analgesic agents could improve patients' consciousness. The neuroendocrine data of the combination group showed little fluctuation, indicating that a combination of sedative and analgesic agents could significantly reduce the stress response. The scores of pain and agitation in the combination group were significantly improved on the 3rd and 5th days, suggesting that the combination group was better compared with the control group.
Conclusion: The combination of Dex and But was more stable for the treatment of vital signs. Compared with the individual treatment groups, the patients in the combination group had a rapid improvement. The time from treatment to stabilization was shortened, and the prognosis was significantly better compared with the control group. A combination of Dex and But at low doses could significantly maintain neuroendocrine stability. Meanwhile, a combination of sedative and analgesic agents had obvious synergistic effects on enhancing sedation and analgesia as well as anti-muscle tension. Collectively, the combination of Dex and But could significantly benefit the prognosis of TBI.
期刊介绍:
Turkish Neurosurgery is a peer-reviewed, multidisciplinary, open access and totally free journal directed at an audience of neurosurgery physicians and scientists. The official language of the journal is English. The journal publishes original articles in the form of clinical and basic research. Turkish Neurosurgery will only publish studies that have institutional review board (IRB) approval and have strictly observed an acceptable follow-up period. With the exception of reference presentation, Turkish Neurosurgery requires that all manuscripts be prepared in accordance with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.