目的：探讨黄体酮（PG）联合维生素D对重型颅脑损伤的治疗价值。方法将98例急性重型颅脑损伤患者按随机数字表法分为PG联合维生素D治疗组（34例），单用PG治疗组（31例）及对照组（33例），比较3组患者治疗后格拉斯哥昏迷评分（GCS）、患者住院期间感染率和病死率、伤后3个月格拉斯哥预后评分（GOS）及预后良好率的差异。结果患者治疗2周的GCS评分PG治疗组与对照组比较差异有统计学意义（P＜0.05），而患者病死率、感染率、伤后3个月GOS评分、伤后3个月预后良好率等方面差异均无统计学意义（均P＞0.05），而PG+维生素D治疗组与其他两组患者伤后2周GCS评分、伤后3个月GOS评分和预后良好率等方面差异均有统计学意义（均P＜0.05），感染率和总体病死率与其他两组差异均无统计学意义（均P＞0.05），但在极重度颅脑损伤（GCS评分3~5分）患者中，与对照组相比，两者的病死率差异有统计学意义（P＜0.05）。结论应用PG联合维生素D治疗急性重型颅脑损伤，可以降低颅脑外伤患者伤后的病死率，促进患者神经功能康复，改善患者的预后。%Objective To evaluate the effect of progesterone (PG) and vitamin D(VD) on the patients with severe brain trauma. Methods 98 patients with acute severe brain injury were randomly assigned into 3 groups:PG+VD group (n=34), PG group (n=31), and control group (n=33). GCS(Glasgow coma scale) 2 weeks after injury, infection rate and mortality during hos-pitalization, GOS (Glasgow outcome scale) and rate of favorable prognosis after three months were compared among these groups. Results There was significant difference in GCS between the PG group and control group after two weeks' treatment (P<0.05), while there were no statistical differences in the infection rate and mortality during hospitalization, GOS and rate of fa-vorable prognosis three months after injury (alP>0.05). There were significant differences in GCS two weeks after injury, GOS and rate of favorable prognosis in PG+VD group and the other two groups (al P<0.05), but no significant differences in infection rate and overal mortality (alP>0.05). However, there were statistical differences in mortality between PG+VD group and control group in extremely severe brain injury (GCS=3~5) patients P<0.05). Conclusion The use of PG and VD in severe brain injury treatment can decrease the mortality, promote the neurological function rehabilitation and improve patients' prognosis.
展开▼
