摘要
目的评价局部脑氧饱和度(rScO2)监测目标导向治疗在重型颅脑损伤(sTBI)的临床应用价值。方法选取2018年4月至2020年11月于内蒙古自治区人民医院神经外科重症监护病房(NSICU)治疗的60例sTBI患者,采用随机数字表法分为试验组和对照组,每组30例。对照组给予神经外科重症传统监护治疗管理,试验组在实施神经外科重症传统监护治疗管理基础上予以rScO2目标监测指导治疗。比较2组患者的NSICU住院时间、出院时GCS评分、并发症发生率、6个月后的死亡率、改良Rankin量表(mRs)评分和GOS评分。结果2组患者出院时GCS评分均高于入院初始评分,且试验组患者出院时的GCS评分高于对照组,但差异均无统计学意义(P>0.05)。试验组患者的NSICU住院时间较对照组明显缩短,差异有统计学意义(P<0.05)。随访6个月,试验组患者mRs评分及GOS评分均明显优于对照组,死亡率明显低于对照组,差异均具有统计学意义(P<0.05)。6个月后,Kaplan-Meier生存曲线分析显示试验组生存时间明显优于对照组,差异有统计学意义(P<0.05)。结论rScO2监测目标导向治疗能有效缩短sTBI患者的NSICU住院时间,降低病死率,改善患者预后。
ObjectiveTo valuate the clinical application of target directed therapy of monitoring regional cerebral oxygen saturation(rScO2)in severe traumatic brain injury(sTBI).MethodsA total of 60 patients with sTBI who were treated in the neurosurgical intensive care unit(NSICU)of Inner Mongolia People's Hospital from April 2018 to November 2020 were randomly divided into experimental group and control group,with 30 patients in each group.The control group was given traditional neurosurgical intensive care management,and the experimental group was given rScO2target monitoring and guidance treatment on the basis of conventional neurosurgical intensive care management.The hospital stay in NSICU,GCS score at discharge,complication rate,mortality after 6 months,modified Rankin scale(mRs)score and GOS score were compared between the two groups.ResultsThe GCS score of both groups at discharge were higher than the initial score at admission,and the GCS scores of the experimental group at discharge were higher than those of the control group,but the difference was not statistically significant(P>0.05).The length of stay in NSICU in experimental group was significantly decreased compared with control group(P<0.05).After 6 months of follow-up,both the mRs score and GOS score in the experimental group were significantly better than those in the control group,and the mortality was significantly lower than that in the control group(P<0.05).Kaplan-Meier survival curve analysis showed that the survival time of experimental group was significantly better than that of control group(P<0.05).ConclusionThe target-directed therapy under the direction of monitoring rScO2can effectively shorten the length of stay in NSICU,reduce the fatality rate and improve the prognosis of patients with sTBI.
作者
王忠
张瑞剑
韩志桐
王俊青
吴日乐
赵卫平
张晓军
包金岗
杨姝敏
杨蔚然
张之龙
Wang Zhong;Zhang Ruijian;Han Zhitong;Wang Junqing;Wu Rile;Zhao Weiping;Zhang Xiaojun;Bao Jingang;Yang Shumin;YangWeiran;Zhang Zhilong(Department of Neurosurgery,Inner Mongolia People's Hospital,Hohhot 010017,China)
出处
《中华神经创伤外科电子杂志》
2022年第5期293-297,共5页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
基金
内蒙古卫健委资助项目(201701009)
内蒙古自治区关键技术攻关计划项目(2019GG051)
关键词
重型颅脑损伤
近红外光谱技术
局部脑氧饱和度
预后
Severe traumatic brain injury
Near-infrared spectroscopy
Regional cerebral oxygen saturation
Prognosis
作者简介
通信作者:张瑞剑,Email:zhangruijian1971@163.com
