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How to use hormones to treat head injury?
How to use hormones to treat head injury? hormone therapy is mainly used in neurosurgical treatment to prevent the formation of brain edema and promote the dissipation of brain edema.
Hormone Therapy for Head Injury
Since researchers reported that adrenal cortex hormones can prevent cerebral edema in 1945, many reports believe that it has a clinical effect, but some people are skeptical about the effect.
At present, hormone therapy is mainly used in neurosurgical treatment to prevent the formation of brain edema and promote the dissipation of brain edema. In some tumors, pituitary adenomas are mainly used to prevent or correct decreased gland function before and after surgery for alternative treatment.
In neurosurgical treatment, the control of intracranial pressure is especially emphasized to prevent brain herniation. Hormones, especially adrenal cortex hormones, play a certain role in preventing and treating cerebral edema through a series of links.
Studies have shown that adrenal cortex hormones can improve or adjust the blood-brain barrier function and reduce capillary permeability. Therefore, it has a better effect on vasogenic brain edema. Similarly, it has a better effect on brain edema with less nerve tissue damage, such as brain tumors or edema around brain abscesses.
For patients with severe brain trauma and brain edema, some authors advocate the use of high-dose hormones to prevent lipid peroxidation through hormones, increase local blood flow and improve the surface of action to reduce secondary damage to traumatic brain tissue.
Many experts pointed out that large ions can prevent the vascular constriction of norepinephrine or serotonin and other biological glues through large doses. It can also prevent the production of prostaglandins and promote anti-thromboxane A2 vasoconstriction and platelets. The agglutinating prostacyclin production surface increases local blood flow.
In brain trauma, due to the enhanced lipid peroxidation reaction, the decrease of local blood flow and the accumulation of calcium ions in the cells and other injury factors, the explosive necrosis of the edema tissue around the trauma is caused, and the lipid peroxidation reaction of the membrane is enhanced. Play a key role in secondary brain damage.
The main reason why high-dose hormones can treat brain trauma and traumatic edema is that it can act on various membrane structures to promote membrane stability, thereby achieving anti-lipid peroxidation, stabilizing ion channels and increasing local blood flow. And so on.
In short, the role of hormones can be summarized into the following three points:
①Due to the anti-inflammatory effect of hormones, it can strengthen cells and cell membranes
②Prevent hyperpermeability of diseased blood vessel wall and cell membrane
③It has a defensive and repairing effect on the damage of the blood-brain barrier. Based on the above three points, hormone therapy for cerebral edema after traumatic brain injury is still valid.
Patients with brain trauma should pay attention to the following matters during the application of hormones:
①Type selection and dosage: According to different hormone mechanisms, dexamethasone (flumethasone) should be the first choice in neurosurgical treatment. Because of its strongest anti-inflammatory effect, the second choice is hydrocortisone, other prednisone or Oral preparations such as prednisolone can be taken after the symptoms are relieved in the acute phase
②Patients using corticosteroids may develop gastrointestinal bleeding and form ulcers, so it is beneficial to routinely apply anti-gastric acid therapy during the treatment process
③Attention should be paid to maintaining the medication time to ensure the maintenance of the local hormone content of the brain injury. The administration must be repeated, and the appropriate dosing regimen must be selected. When corticosteroids are applied, it can temporarily inhibit the activity of human endocrine. After short-term application of the drug, normal endocrine can be restored within a few days, but long-term application will recover slowly, so the dose should be gradually reduced and then the drug should be stopped.
④Because hormones have the effect of inhibiting the formation of fibroblasts and can affect the healing of surgical wounds, attention should be paid
⑤Adrenal cortex hormone has the side effect of reducing the body’s immunity, so it can increase the chance of local or systemic infection. For patients who are unconscious or have infection, antibiotics should be added to prevent or treat infection in time.
(source:internet, reference only)