Lucena Lynne Lourdes N, Briones Marla Vina A
Department of Surgery, Bicol Regional Training and Teaching Hospital, Philippines.
Independent Researcher, Naga City, Philippines.
Clin Neurol Neurosurg. 2022 May;216:107216. doi: 10.1016/j.clineuro.2022.107216. Epub 2022 Mar 23.
Severe traumatic brain injury (TBI) patients with nonoperative lesions are known to have a poorer prognosis. Recent and ongoing clinical studies have been exploring the utility of Cerebrolysin in improving patient outcomes among TBI patients; however, few studies are available on the effect of Cerebrolysin among nonoperative severe TBI patients.
To determine the effects of Cerebrolysin as add-on therapy to the standard medical decompression protocol for nonoperative severe TBI patients.
The study employed a retrospective cohort design and included 87 severe TBI patients on admission. In addition to the current medical decompression protocol, 42 patients received 30 ml/day Cerebrolysin for 14 days, followed by a subsequent 10 ml/day dosage for another 14 days. The control group included 45 patients who received the standard decompression protocol only. Stata MP version 16 was used for data analysis.
Compared to the control group, a significantly higher proportion of patients who received Cerebrolysin treatment achieved a favourable outcome at Day 21 post-TBI (50% vs. 87%; p < 0.00001) and GOS ≥ 4 (18% vs. 39%; p = 0.043). The mean length of hospital stay was approximately seven days shorter in the Cerebrolysin group (25.61 days vs. 31.92 days; p < 0.00001), and a significantly lower proportion of Cerebrolysin patients had a LOS ≥ 30 days (Cerebrolysin: 13%; Control: 51%; p < 0.0001). No significant group differences were seen in the 28-day mortality rate.
Cerebrolysin is beneficial for severe TBI patients with nonoperative lesions as evidenced by stronger improvement in GCS/GOS and shorter length of hospital stay than standard treatment alone.
已知非手术性损伤的重度创伤性脑损伤(TBI)患者预后较差。近期及正在进行的临床研究一直在探索脑蛋白水解物在改善TBI患者预后方面的效用;然而,关于脑蛋白水解物对非手术性重度TBI患者影响的研究较少。
确定脑蛋白水解物作为非手术性重度TBI患者标准药物减压方案附加治疗的效果。
本研究采用回顾性队列设计,纳入87例入院时的重度TBI患者。除现行的药物减压方案外,42例患者接受每日30毫升脑蛋白水解物治疗,持续14天,随后每日10毫升剂量再持续14天。对照组包括45例仅接受标准减压方案的患者。使用Stata MP 16版进行数据分析。
与对照组相比,接受脑蛋白水解物治疗的患者在TBI后第21天获得良好预后的比例显著更高(50%对87%;p<0.00001),且格拉斯哥预后评分(GOS)≥4的比例更高(18%对39%;p = 0.043)。脑蛋白水解物组的平均住院时间约短7天(25.61天对31.92天;p<0.00001),且脑蛋白水解物组患者住院时间≥30天的比例显著更低(脑蛋白水解物组:13%;对照组:51%;p<0.0001)。28天死亡率无显著组间差异。
脑蛋白水解物对非手术性损伤的重度TBI患者有益,与单纯标准治疗相比,其在格拉斯哥昏迷量表/格拉斯哥预后评分方面改善更明显,住院时间更短。