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[吡拉西坦用于重型颅脑损伤]

[Piracetam in severe cranio-cerebral injuries].

作者信息

Gościński I, Sliwonik S, Sondej T, Kwiatkowski S, Moskała M, Cichoński J, Wegrzyn D, Uhl H

机构信息

Kliniki Neurotraumatologii Instytutu Neurologii Collegium Medicum UJ.

出版信息

Neurol Neurochir Pol. 1998 Sep-Oct;32(5):1189-97.

Abstract

A group of 100 patients treated immediately following a cranio-cerebral injury was analyzed. The patients, administered piracetam either in an intravenous infusion (GCS 3-8) or orally (GCS above 9), were divided into groups depending on the dose and clinical status. Piracetam participates in the activity of the majority of neurotransmitters, increases glucose and oxygen consumption in the ischaemic nervous tissue and increases blood flow through cerebral terminal vessels. In cranio-cerebral injuries, piracetam is employed to achieve cytoprotection and improve cerebral blood flow. In patients with neurological deterioration following the administration of 6-10 mg/day, no good results were obtained. A dose of 24-30 mg/day had a significant positive effect on therapeutic results providing certain conditions were met, such as ensuring proper partial oxygen pressure (oxygen therapy) and proper blood glucose levels. The use of piracetam is justified immediately after an injury; after the discharge oral piracetam therapy is recommended.

摘要

对一组100例颅脑损伤后立即接受治疗的患者进行了分析。这些患者,根据格拉斯哥昏迷评分(GCS),3 - 8分的患者接受静脉输注吡拉西坦,9分以上的患者口服吡拉西坦,并根据剂量和临床状况分组。吡拉西坦参与大多数神经递质的活动,增加缺血神经组织中的葡萄糖和氧气消耗,并增加通过脑末梢血管的血流量。在颅脑损伤中,吡拉西坦用于实现细胞保护和改善脑血流量。在每天服用6 - 10毫克后出现神经功能恶化的患者中,未取得良好效果。在满足某些条件(如确保适当的部分氧分压(氧疗)和适当的血糖水平)的情况下,每天24 - 30毫克的剂量对治疗结果有显著的积极影响。损伤后应立即使用吡拉西坦;出院后建议进行口服吡拉西坦治疗。

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