弥漫性轴索损伤的综合治疗对预后的影响  

The effect of combination therapy for diffuse axonal injury on prognosis of patients.

作　　者：林其昌[1] 林少华[1] 黄汉添[1] 

机构地区：[1]中山市人民医院神经外科,广东中山528400

出　　处：《临床和实验医学杂志》2006年第5期504-506,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨弥漫性轴索损伤(D IA)临床诊断及综合治疗手段,提高D IA病人的生存率及生存质量。方法将96例D IA病人分成两组,对照组给予常规的脱水、止血、及神经营养及高压氧治疗,治疗组在常规治疗基础上再给予亚低温、镁离子、甲基强的松龙冲击、神经节苷酯的综合治疗。患者于伤后7 d进行颅内压测定,1个月作格拉斯哥昏迷评分(GCS)评分、6个月作格拉斯哥治疗结果分级(GOS)评分评估预后。结果综合治疗组预后明显优于对照组。结论早期给予亚低温、镁离子、甲基强的松龙冲击、神经节苷酯的综合治疗能有效抑制轴索继发性损伤的发生、发展。明显提高病人的生存率及生存质量。Objective To study the clinical diagnosis of and combination therapy for diffuse axonal injury（DAI） in order to improve the survival rate and quality of life of the patients, Methods Ninety - six patients with DAI were randomly divided into two groups ： the control group patients were treated with routine treatment（ e. g. dehydration, hemostasis, neuronutrition and hyperbaric oxygen）, the combination treatment group patients were treated with comprehensive treatment（ include mild hypothermia , magnesium sulfate, aggressive dosage of methylprednisolone and ganglioside as well as routine treatment） . Intracranial pressures （ICP） were measured on the 7th day after injury, Glasgow Coma Scale （GCS） scores were evaluated 1 month after the injury, Glasgow outcome scale（GOS） scares were evaluated 6 month after the injury. Results the prognosis of the patients in the combination treatment group was significantly better than those in the control group, Conclusion Mild hypothermia , magnesium sulfate, aggressive dosage of methylprednisolone and ganglioside can suppress secondary injury of axon , improve survival rate and quality of life of the patients.

关 键 词：综合治疗 弥漫性轴索损伤 预后 

分 类 号：R651.15[医药卫生—外科学] R730.264[医药卫生—临床医学]