摘要
目的为了探讨急诊救治措施在外源性颅脑损伤预后中发挥的作用,从而为外源性颅脑损伤的治疗提供依据。方法选取2016年1月至2019年12月在晋中市第一人民医院急诊科接受治疗的251例格拉斯哥昏迷指数(GCS)评分为3~8分的颅脑损伤患者作为观察对象,在其入院前统计患者基础信息、GCS评分、到达神经外科ICU时的收缩压、脉搏血氧饱和度等信息,将251例患者随机分为两组,对照组(n=125)采取常规救治措施,观察组(n=126)采取急诊救治措施,主要包括气管插管给氧、体液复苏、使用甘露醇等,观察两组患者抢救成功情况、ICU住院时长、出院时的格拉斯哥预后评分(GOS)、肺部感染、应激性溃疡、多器官功能衰竭,以及患者8 h后的脑血流动力学变化情况。结果对照组抢救成功率为87.86%,观察组抢救成功率为100.00%;对照组患者ICU平均住院时间(10.52±3.24)d,高于观察组的(7.64±2.73)d;在出院时和伤后第6个月GOS分级方面,观察组GOS分级在3~5级的患者数显著高于对照组的患者数,对照组患者GOS分级普遍分布在1、2级;观察组肺部感染、应激性溃疡、多器官功能衰竭发生率为7.93%、6.35%、9.52%、低于对照组的21.60%、16.00%、20.00%;患者8 h后的脑血流动力学变化情况,观察组患者明显优于对照组,以上结果差异均有统计学意义(P<0.05)。结论无论是从抢救成功率还是恢复时间抑或是预后指标来看,观察组的治疗以及预后效果都显著高于对照组,说明急诊救治措施是外源性颅脑损伤的治疗中相当必要的一环,这为急诊救治措施在治疗中的重要性提供了重要依据。
Objective To explore the role of emergency rescue measures in the prognosis of exogenous craniocerebral injury(ECI),so as to provide a basis for the treatment of ECI.Methods A total of 251 patients with craniocerebral injury and Glasgow Coma Scale(GCS)score of 3-8 points who were treated in the emergency department of the First People's Hospital of Jinzhong from January 2016 to December 2019 were selected as the observation objects.The basic information and GCS score of patients were recorded before admission,the systolic blood pressure and pulse oxygen saturation at the time of arrival at the neurosurgical intensive care unit(ICU)were also counted.The 251 patients were randomly divided into two groups,with the control group(n=125)receiving conventional rescue measures and the observation group(n=126)receiving emergency rescue measures,mainly including tracheal intubation for oxygen inhalation,fluid resuscitation,use of mannitol,etc.The success rate of resuscitation,length of ICU monitoring,Glasgow Outcome Scale(GOS)score at discharge,pulmonary infection,stress ulcer,multiple system organ failure,and cerebral hemodynamic changes after 8 h in both groups of patients were observed.Results The success rate of resuscitation was 87.86%in the control group and 100.00%in the observation group.The average length of stay in the ICU was(10.52±3.24)days in the control group in the observation group,was significantly longer in the control group than in the(7.64±2.73)days of observation group.In terms of GOS grading at discharge and at the sixth month after injury,the number of patients with GOS grade of 3-5 was higher in the observation group than in the control group,and most of the patients in the control group with GOS grade of 1 and 2.The incidence of pulmonary infection,stress ulcer,and multiple system organ failure in the observation group was 7.93%,6.35%,and 9.52%,respectively,which was lower than that of the control group(21.60%,16.00%,and 20.00%,respectively).In addition,the cerebral hemodynamic indexes after 8 h in the observation were better than those in the control group.All the above results showed statistically significant differences between the two groups(P<0.05).Conclusion The efficacy and prognosis of the patients in observation group were significantly better than those in the control group in terms of the success rate of resuscitation,recovery time and prognostic indexes,indicating that emergency rescue treatment is a necessary part of the treatment of ECI,which provides an important basis for the importance of emergency rescue treatment.
作者
李树贵
王梦原
LI Shugui;WANG Mengyuan(Emergency Department,the First People's Hospital of Jinzhong,Shanxi,Jinzhong 030600,China)
出处
《中国医药科学》
2021年第23期214-217,共4页
China Medicine And Pharmacy
关键词
外源性颅脑损伤
急诊救治措施
预后
术后恢复
Exogenous craniocerebral injury
Emergency rescue measures
Prognosis
Postoperative recovery
