METHODS: A cohort of 56 patients was included in this non-randomised, real-time, pre-post-interventional study. The patients were assessed with the Glasgow Coma Scale (GCS) and divided into two groups: severe (GCS < 8) and non-severe (GCS > 8). After the radiological examination (CT scan), the patients were qualified for an immediate neurosurgical procedure if needed. The patients were admitted to the intensive care unit, where a standardised protocol for TBI treatment was implemented. Additional neuromonitoring was applied.
RESULTS: There were 56 patients (19 females; 33.9%), of which 41 were considered severe cases; the patients were allocated to the Cerebrolysin (n = 25) or control groups (n = 31). In a generalised linear model (GLM) approach, the use of Cerebrolysin was associated with a decrease in the probability of death in non-severe patients (by 0.333 (standard error (SE) = 0.157, p = 0.034)) but not in severe patients (estimate (Est.) = -0.115, SE = 0.127, p = 0.364). Patients who received Cerebrolysin and who were neuromonitored had favourable outcomes and better survival rates.
CONCLUSIONS: A multimodal treatment approach with monitoring and Cerebrolysin may have a beneficial effect on patients with less severe TBIs; however, the present study has multiple limitations, and further research is needed.
方法:本研究纳入了56名患者的非随机队列,实时,介入研究前。采用格拉斯哥昏迷量表(GCS)对患者进行评估,并分为两组:重度(GCS<8)和非重度(GCS>8)。放射学检查(CT扫描)后,如果需要,患者有资格立即进行神经外科手术。病人被送进了重症监护室,实施了标准化的TBI治疗方案。应用额外的神经监测。
结果:有56例患者(19例女性;33.9%),其中41例被认为是严重病例;患者被分配到脑活素组(n=25)或对照组(n=31)。在广义线性模型(GLM)方法中,脑活素的使用与非重度患者的死亡概率降低相关(降低0.333(标准误差(SE)=0.157,p=0.034)),但与重度患者的死亡概率无关(估计(Est.)=-0.115,SE=0.127,p=0.364)。接受脑活素和神经监测的患者具有良好的预后和更好的生存率。
结论:监测和脑活素的多模式治疗方法可能对TBI严重程度较低的患者有有益效果;然而,本研究有多重局限性,需要进一步的研究。