神经内科昏迷患者临床诊断及治疗体会

Clinical diagnosis and treatment experience in neurological coma patients

目的观察并探讨神经内科昏迷患者临床诊断方法及治疗体会。方法 94例神经内科昏迷患者,回顾性分析所有患者的临床资料,总结患者的昏迷原因及死亡原因,观察治疗效果。结果昏迷原因有糖尿病、脑血管疾病、急性中毒、其他疾病;患者经过抢救,成功率为95.74%,死亡率为4.26%,死亡原因分别为颅内感染、脑血管疾病、急性中毒以及糖尿病各1例;所有患者治疗前动脉血氧饱和度(Sa O2)、动脉血氧分压(Pa O2)、呼吸频率(RR)、动脉血二氧化碳分压(Pa CO2)水平分别为(71.59±4.74)%、(57.63±5.92)mm Hg(1 mm Hg=0.133 k Pa)、(40.28±5.14)次/min、(58.16±5.42)mm Hg,治疗后Sa O2、Pa O2、RR、Pa CO2水平分别为(98.48±1.24)%、(87.51±4.21)mm Hg、(21.40±2.29)次/min、(32.71±3.86)mm Hg,患者治疗后Sa O2、Pa O2、RR、Pa CO2水平明显优于治疗前,差异具有统计学意义(P<0.05)。结论短时间内对神经内科昏迷患者的患病原因及具体病情给予确定,对于提升抢救效果具有推动作用,并且根据患者病情给予高度合理性、针对性的治疗方案,能够产生良好的预后效果。

Objective To observe and investigate the clinical diagnostic method and treatment experience of neurological coma patients. Methods The clinical data of 94 neurological coma patients were retrospectively analyzed. The causes of coma and the causes of death were summarized, and the treatment effect was observed. Results Coma patients included diabetes, cerebrovascular disease, acute severe disease and other diseases patients. After rescue, the success rate was 95.74% and the mortality rate was 4.26%. The causes of death were intracranial infection, cerebrovascular disease, acute poisoning and diabetes. All patients had blood oxygen saturation （SaO2）, oxygen partial pressure （PaO2）, respiratory rate （RR） and partial pressure of carbon dioxide （PaCO2） level respectively as （71.59±4.74）%, （57.63±5.92） mm Hg （1 mm Hg=0.133 kPa）, （40.28±5.14） times/min and （58.16±5.42） mm Hg before treatment, which were （98.48±1.24）%, （87.51±4.21） mm Hg, （21.40± 2.29） times/min and （32.71±3.86）mm Hg after treatment. Patients had obviously better SaO2, PaO2, RR and PaCO2 level after treatment than before treatment, and the difference was statistically significant （P〈0.05）. Conclusion The short-term determination of the cause of disease and the specific condition of neurological coma patients has a positive effect on improving the rescue effect, a highly rational and targeted treatment regimen according to the patient’s condition can produce good prognostic effect.