关键词: 重型颅脑损伤, 脑血管痉挛, 康复训练, 纳美芬, 内皮素-1, 一氧化氮

Abstract: Objective To explore the effect of rehabilitation training combined with Nalmefene on acute cerebral vasospasm of severe craniocerebral injury and its effect on endothelin-1 (ET-1) and nitric oxide (NO) production. Methods Seventy four patients with severe craniocerebral injury in the hospital were selected from January 2015 to December 2017. The patients were randomly divided into the control group (group A) and the observation group (group B), with 37 cases in each. The group A was treated with routine treatment combined with rehabilitation training whereas group B was additionally given Nalmefene. After 2 weeks of treatments, the two groups of patients were compared for blood flow velocity, incidence of cerebral vasospasm, Glasgow coma score, ET-1 and NO level, Fugl-Meyer assessment scale (FMA), and the Barthel index rating scale (BI) score. Results The blood flow velocity of all the patients in the two groups decreased following the treatments, particularly in group B when compared with the control (P<0.05). The incidence of CVS in group B was significantly lowered (P<0.05). After treatments, the GCS score of group B was significantly elevated (P<0.05). The ET-1 level of the cerebrospinal fluid in group B was decreased and the NO production was notably higher than that of the control (P<0.05). Generally, the scores of FMA and BI in both groups were improved but more obviously in group B than group A (P<0.05). Conclusion The combined therapy of rehabilitation training and Nalmefene may effectively reduce the secondary injury of brain tissues and help for amelioration of cerebral vasospasm, promotion of the recovery of consciousness and reduction of the ET-1 expression.

Key words: Severe, craniocerebral, injury, Cerebral, vasospasm, Rehabilitation, training, Nalmefene, Endothelin-1, Nitric, oxyde