Abstract:

To investigate the clinical adjunctive therapeutical effect of creatine phosphate on the patients with acute severe head injury during operation to provide key material for study on its clinic therapeutic application.Methods 40 patients with acute severe head injury underwent operation were randomly divided into creatine phosphate group and control group.The patients in creatine phosphate group were injected with creatine phosphate（2 g）during operation.The patients in control group were administrated with saline i.v.with the same volume.mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),stroke volume index(SI),pulmonary vascular resistance(PVR),intracranial pressure(ICP) and  brain partial pressure of oxygen(PbrO2)were recorded at pretreatment(T1),after administration (T2),after dura incision (T3),2 h after administration (T4) and after operation（T5）.The content of protein S100β　of per-patient was measured before and 24 h after operation,the cases of complication such as nausea,shivering and so on during operation were recorded after operation,according to Glasgow Outcome Scale(GOS),the prognosis of the patients was evaluated.   Results There was no markedly variation about MAP and HR between two groups on each time during opertion（P>0.05）.Compared with control group,CO and SI were significantly higher in creatine phosphate group during operation（t=4.019，P<0.05）at T2-T5,at the same time PVR in creatine phosphate group was notably lower than that in control group（t=3.517，P<0.05）. After operation,ICP in creatine phosphate group was notably lower than that in control group,at the same time PbrO2 in control group was significantly higher than that in creatine phosphate group（P<0.05）.After operation,the content of protein S100β in control group was significantly increased compared with  before operation（P<0.05）.The patients with  GOS from grade Ⅰ to Ⅴ in creatine phosphate group were 9 cases,4 cases,2 cases,3 cases and 2 cases and those were  2 cases,4 cases,6 cases,2 cases and 6 cases in control group（U=116.10，P<0.05）.The effective rate in creatine phosphate group was higher than that in control group(P<0.05).
Conclusion Administration of creatine phosphate can increase myocardium contractility in patients with acute severe head injury during operation in earlier period,and can improve the microcirculation and energy metabolism of the heart and brain constitutions,and promote the rehabilitation of patients.

Key words: creatine phosphate；craniocerebral trauma；energy metabolism