镁离子结合机械通气早期治疗重型弥漫性轴索损伤的临床疗效

Severe diff use ax onal injury treated by magnesium sulfate with artificial ventilation

目的观察联合使用硫酸镁结合机械通气早期治疗重型弥漫性轴索损伤的临床疗效。方法将武警广东省总队医院神经外科自2011年1月至2014年12月收治的96例重型弥漫性轴索损伤患者伤后24 h内随机分成常规组(42例,接受常规综合治疗)、治疗组(54例,除常规治疗方法外,加用25%硫酸镁治疗结合机械通气治疗)进行分别治疗。观察治疗7 d后各组监测血压、呼吸、心率、体温和血气分析变化情况,及治疗前后GCS评分和3个月后GOS评级情况并进行疗效分析。结果治疗7 d后监测指标变化情况比较,治疗组患者各项指标改善高于常规组,且差异有统计学意义(P<0.05);在入院治疗后1周、2周,治疗组GCS评分高于常规组,且差异有统计学意义(P<0.05),3个月后GOS评级亦明显高于常规组,且差异有统计学意义(P<0.05)。结论硫酸镁结合机械通气对早期治疗重型弥漫性轴索损伤能改善预后转归,降低病死率。

Objective To observe the clinical effect of combined magnesium sulfate and artificial ventilation in the treatment to severe diffuse axonal injury. Methods 96 cases of diffuse axonal injury with in 24 h were randomly divided into general group （n=42, undergoing conventional comprehensive treatment ） and treatment group （ n=54 , undergoing magnesium sulfate treatment in combination with artificial ventilation in addition of conventional comprehensive treatment）. Observe to each group’s blood pressure, respiration, heart rate, body temperature and blood gas changes after 7 d treatment, and the GCS score before and after treatment and 3 months after the GOS score of the situation for efficacy analysis. Results After treatment 7 d indicators for monitoring changes in the treated group were significantly higher than the indicators to improve the general group （ P〈0.05）; in the hospital 7 d after treatment, 14 d the treatment group GCS score was significantly higher than the general group （P〈0.05）, 3 months after the GOS score was significantly higher than the general group （P〈0.05）. Conclusion Magnesium sulfate combined with artificial ventilation can improve clinical efficacy for DA, increase the quality of life and decrease the mortality.