二次脑损伤因素对重症颅脑损伤患者预后影响的临床研究

目的:观察和分析二次脑损伤因素(SBI)对重型颅脑损伤患者预后的影响。方法:将2003年12月至2007年6月收治的重型颅脑损伤患者162例随机分为实验组和对照组。实验组对二次脑损伤因素(发热、低血压、低氧血症、心跳过速等)进行干预,观察两组间SBI变化规律;GOS预后评分比较两组患者6个月后的治疗结果。χ2检验比较两组数据的统计学意义。结果:实验组对SBI因素干预后其低血压、低氧血症发生数较对照组明显降低(P<0.05),6个月后GOS预后评分实验组死亡率较对照组明显降低(P<0.02),治愈率较对照组明显提高(P<0.01)。结论:加强对SBI因素的干预可有效降低重型颅脑损伤患者的死亡率,提高治疗率。

Objective:To study and evaluate the effects of secondary brain insults(SBIs)on the functional outcomes in severe brain injured patients. Methods:162 severe brain injured patients,hospitalized from Dec.2003 to Jun.2007,were randomized into experimental group and control group; We intensively prevent and control the factors of SBIs in the experimental group,the occurrence of SBIs was observed in two groups,Glasgow Outcome Scale scores(GOS)was used to evaluate and compare the clinical outcomes of two groups six month later. Resutls:After intensive intervention,the incidence of SBIs factors such as hypotension and hypoxia in experimental group decease significantly(P<0.05)compared with control group. The mortality of patients in experimental group reduced(P<0.02)and the cure and improvement rate increased(P<0.01)when the clinical outcomes of patients were evaluated with GOS six months later. Conclusion:Intensive intervention on SBIs factors might effectively reduce the mortality and improve the cure and improvement rate of severe brain injured patients.