探讨重型颅脑损伤后肺部并发症与GCS、预后的评价

Craniocerebral Injury with Pulmonary Complications and Prognosis of GCS Evaluation

目的:探讨重型颅脑损伤肺部并发症与格拉斯哥昏迷指数GCS评分及患者预后的相关性。方法2012年10月~2013年9月重型颅脑损伤合并肺部并发症病例42例均行急诊颅内血肿清除手术治疗颅脑损伤,每日给予青霉素钠480万U+氨苄青霉素6 g静脉滴注,2次/d进行肺部感染控制。结果42例肺部感染患者中,7 d内获得控制者32例,GCS评分(5.8±0.4)分,明显低于7 d内未控制患者评分(7.2±0.5)分,数据间比较差异具有统计学意义(<0.01)。7 d内获得控制患者的生存率明显高于、死亡率明显低于未获得控制者,GCS评分为5分患者的生存率明显低于、死亡率明显高于评分为6~8分患者,数据间比较差异具有统计学意义(<0.01)。结论重型颅脑损伤后肺部并发症的控制情况与患者GCS评分及预后情况具有相关性,早期进行肺部感染的有效控制,有利于改善患者GCS水平,提高预后。

Objective To study the severe craniocerebral injury patients with pulmonary complications and Glasgow coma scale GCS score and the prognosis of correlation.Methods In October 2012 to September 2013 cases of severe craniocerebral injury with pulmonary complications in 42 cases underwent emergency intracranial hematoma removal surgery in the treatment of traumatic brain injury,daily to give U+4.8 mil ion penicil in sodium ampicil in 6 g intravenous drip,2 times/d for lung infection control.Results 42 cases of pulmonary infection patients,7 d control er for 32 cases,GCS score(5.8~0.4),significantly lower than in the 7 d control patients score(7.2~0.5)points,comparing dif erences between data statistical y significant(<0.01).Within 7 d for survival rate of patients was obviously higher than that of control,mortality is significantly lower than for control ers,GCS score of 5 points of the patient's survival rate was significantly lower than,mortality is significantly higher than the score of patients 6 to 8 points,and comparison between data statistical y significant dif erence(<0.01).Conclusion Control of pulmonary complications after severe head injury patients with GCS score and prognosis of correlation,the effective control of early lung infection,is beneficial to improve the level of patients with GCS,improve the prognosis.