急性中、重型颅脑损伤并发全身炎症反应综合征的临床观察  

Clinic study of systemic inflammatory response syndrome induced by acute medium and severe craniocerebral trauma

作　　者：张大健[1] 

机构地区：[1]安徽省宿州市中煤三建总医院ICU,234000

出　　处：《淮海医药》2009年第5期406-407,共2页Journal of Huaihai Medicine

摘　　要：目的观察急性颅脑损伤程度与全身炎症反应综合征(SIRS)的关系及其对预后的影响。方法回顾性分析52例急性中、重度颅脑损伤患者中SIRS发生与病情程度、预后的关系,SIRS组再根据诊断标准项目符合数分组,分别比较各组病例的病死率。结果急性中、重度颅脑损伤SIRS的发生率高达84.6%,与病情程度有一定关系,病情越重,GCS评分越低,SIRS发生率越高(P<0.05);SIRS组的病死率显著高于非SIRS组(P<0.05),且病死率随着SIRS的严重程度增加而增加(P<0.05)。结论急性中、重度颅脑损伤常诱发SIRS,SIRD的发生与预后有关,应结合是否发生SIRS来综合判断中、重度颅脑损伤患者的病情程度,SIRS的发生及严重程度可作为急性中、重度颅脑损伤患者预后判断及指导治疗的指标。Objective To study the relationship between the systemic inflammatory response syndrome （SIRS）and aeut medium, or severe craniocerebral trauma, and to discuss the prognosis of SIRS patients. Methods 52 patients with acute medium or severe craniocerebral trauma were analyzed retrospectively. According to the standard of SIRS diagnosis , the relationship between severity of disease and SIRS, SIRS and prognose were stdutied. Patients with SIRS were divided into three groups ,the mortality rate was compared in every group. Results Among the 52 patients 84.6% were complicated with SIRS. The occurrence of SIRS had some correlation with GCS scale. The higher occurrence rate of SIRS was accociated with the lower GCS scale （ P 〈 0.05 ）. The mortality rate of SIRS patients was higher than that in the control group （ P 〈 0.05 ）. Moreover, the mortality rate rose with the severity of SIRS （ P 〈 0.05 ）. Condusion The acute medium or severe craniocerebral trauma is usually complicated with SIRS. The occurrence of SIRS after brain injury tends to lead to clinical worsening and a poor outcome. The occurrence and severity of SIRS should be taken as indexes in guiding treatment and judging outcome.

关 键 词：颅脑损伤 全身炎症反应综合征 预后 

分 类 号：R651.15[医药卫生—外科学]