早期腰大池持续引流联合硫酸镁治疗弥漫性轴索损伤的效果及安全性

Efficacy and safety of early continuous lumbar cistern drainage combined with magnesium sulfate for diffuse axonal injury

目的总结分析早期腰大池持续引流联合硫酸镁对弥漫性轴索损伤治疗的临床效果以及治疗安全性。方法选取2014年8月~2017年8月我院收治的80例弥漫性轴索损伤患者作为研究对象,按照随机数字表法分为观察组与对照组,每组各40例。对照组早期给予腰大池持续引流,观察组早期给予腰大池持续引流+硫酸镁,比较两组患者的临床疗效及安全性。结果观察组患者治疗后的日常生活能力评分(ADL)、格拉斯哥昏迷指数(GCS)评分、简易精神状态量表(MMSE)评分均高于对照组,差异有统计学意义(P<0.05);观察组患者预后的植物生存率低于对照组,差异有统计学意义(P<0.05);两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论早期腰大池持续引流联合硫酸镁治疗弥漫性轴索损伤,有利于改善患者预后,提高患者生活和精神状态,同时用药安全性高,值得推广应用。

Objective To summarize and analyze the clinical efficacy and treatment safety of early continuous lumbar cistern drainage in combination with magnesium sulfate for diffuse axonal injury（DAI）. Methods Eighty DAI patients admitted to our hospital from August 2014 to August 2017 were selected as study objects. According to the random number table method, they were divided into observation group and control group, with 40 cases in each group. In the control group, early continuous lumbar cistern drainage alone was used, while in the observation group, early continuous lumbar cistern drainage plus magnesium sulfate was adopted. The clinical efficacy and safety of the two groups were compared. Results After treatment, the activity of daily living（ADL） score, Glasgow Coma Scale（GCS） score and Mini-Mental State Examination（MMSE） score in the observation group were all higher than those in the control group,with statistical significances（P〈0.05）. In the observation group, the survival rate of vegetative was lower than that in the control group, with a significant difference（P〈0.05）. There was no significant difference in incidence of complications between the two groups（P〈0.05）. Conclusion The combination of early continuous lumbar cistern drainage and magnesium sulfate for DAI is beneficial to patient′s prognosis improvement as well as the life and mental state amelioration. At the same time, the drug safety is high, and it is worthy of promotion and application.