| Purpose: Explore the changes to 1H-MRS, a metabolite in the brain of patients suffering diffuse axonal injury(DAI), in different periods, observe how angoniuhuang pill injection changes the N-acetyl asparte(NAA) and choline(Cho) in the brains of DAI patients, and evaluate the influence of angoniuhuang pill injection on prognosis. Methods: Choose 36 patients, aging from 20 to 50, hospitalized from October 2012 to October 2014 in the Neurosurgery Department, with 26 male patients and 10 female ones. Selection standards: a clear history of trauma; an after-injury coma lasting for over 30 minutes;6-15 points in the GCS scoring; hospitalization within 24 hours after the injury; without defined vital signs of neurological orientation; iconography or clinical results support diagnosis; without a metal trachea catheter; stable vital signs. Rule-out standards: obvious intracranial hematoma; pregnant women are excluded; patients with serious injuries in other systems; patients who suffer heart disease or cerebral vascular disease before the injury; patients who show no cooperation in the examination. Divide the patients into two groups according to the random number table; there are no statistical differences between the two groups in terms of GCS scoring, gender and age. The Reference Group receives the basic treatment, while the Treatment Group receives a daily venous injection of 5% GS 250 m L + 20 m L angoniuhuang pill injection in addition to the basic treatment. Both groups receive the same basic treatment, which maintains the balance of water-salt electrolyte, supplies nutrients, controls blood pressure, and manipulates body temperature. Both groups receive the GCS scoring 24 hours after the injury and 15 days and 30 days after the treatment respectively; make quantitative analysis of NAA/Cr and Cho/Cr of 1H-MRS.(MR is provides by the Affiliated Hospital of Luzhou Medical College, Philips, Holland Company, 3.0T). Define the location and nature of the injury through the regular skull MRI examination, select the area under the wave crest of various 1H-MRS indicators in callosum knee, splenium and basal ganglia, and calculate the area ratio of the indicators and Cr, with NAA/Cr and Cho/Cr representing the relative content in the brain respectively. Results: 1. There is no difference between the two groups of patients with slight-medium injury in terms of age and gender, and the change bears no correlation with the GCS scoring. 2. The GCS scoring of the Treatment Group and the Reference Group: There is change to the GCS score of the Treatment Group 15 days and 30 days after the treatment in comparison with the Reference Group(P<0.05), and the change can improve the prognosis. 3. The quantity of the NAA/Cr and Cho/Cr in the brains of the two groups: the quantity of the NAA/Cr is higher than that of the regular treatment on the 15 th day and the 30 th day after the treatment with angoniuhuang pill injection(P<0.05) while the Cho/Cr is lower(P<0.05). Conclusions: 1. 1. The 1H-MRS examination can be used as a powerful tool to assess the seriousness and prognosis of patients with brain trauma and is of significant value in defining the location and extent of the injury of DAI patients. 2. Angoniuhuang pill injection can improve the metabolism and cellular functions in the brain, reduce the damage to neurons and cell membranes, promote the metabolism of the compounds in the brain, accelerate the recovery of awareness and protect the brain. |
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