Eisenberg H M, Frankowski R F, Contant C F, Marshall L F, Walker M D
Division of Neurosurgery, University of Texas Medical Branch, Galveston.
J Neurosurg. 1988 Jul;69(1):15-23. doi: 10.3171/jns.1988.69.1.0015.
In a five-center study, 73 patients with severe head injury and elevated intracranial pressure (ICP) were randomly assigned to receive either a regimen that included high-dose pentobarbital or one that was otherwise similar but did not include pentobarbital. The results indicated a 2:1 benefit for those treated with the drug with regard to ICP control. When patients were stratified by prerandomization cardiac complications, the advantage increased to 4:1. A multiple logistic model considering treatment and selected baseline variables indicated a significant positive treatment effect of barbiturates, a significant effect of time from injury to randomization, and an interaction of treatment with cardiovascular complications. However, of 925 patients potentially eligible for randomization, only 12% met ICP randomization criteria. The results support the hypothesis that high-dose pentobarbital is an effective adjunctive therapy, but that it is indicated in only a small subset of patients with severe head injury.
在一项五中心研究中，73例重度颅脑损伤且颅内压（ICP）升高的患者被随机分配接受包含大剂量戊巴比妥的治疗方案或其他方面相似但不包含戊巴比妥的治疗方案。结果表明，接受该药物治疗的患者在控制ICP方面的获益比为2:1。当根据随机分组前的心脏并发症对患者进行分层时，优势增加至4:1。一个考虑治疗和选定基线变量的多因素逻辑模型表明，巴比妥类药物具有显著的积极治疗效果，从受伤到随机分组的时间有显著影响，且治疗与心血管并发症之间存在相互作用。然而，在925例可能符合随机分组条件的患者中，只有12%符合ICP随机分组标准。结果支持了以下假设：大剂量戊巴比妥是一种有效的辅助治疗方法，但仅适用于一小部分重度颅脑损伤患者。
