重型弥漫性轴索损伤早期治疗28例预后分析  

Prognosis Analysis on Early Therapy Strategy in 28 Cases with Severe Diffuse Axonal Injury

作　　者：余长河 胡文杰 

机构地区：[1]安徽省蚌埠市五河县人民医院ICU,233000

出　　处：《解剖与临床》2012年第4期322-324,共3页Anatomy and Clinics

摘　　要：目的：探讨重型弥漫性轴索损伤（DAI）早期处理对策。方法：2007年1月～2011年10月收治重度弥漫性轴索损伤患者28例，均于伤后12h内给予集束化治疗，包括钙离子拮抗剂、亚低温治疗、控制血糖、阿片受体拮抗剂应用、防止应激性溃疡、肠内外营养支持以及合并伤早期处理，维持呼吸循环稳定；后期可行高压氧治疗。结果：采用门诊或电话随访，并根据格拉斯哥预后评分：本组28例患者中死亡6例，植物生存6例，重残5例，中残4例，良好7例。结论：重型DAI早期集束化治疗可明显降低患者的死亡率和致残率。Objective：To discuss the early treatment of the patients with diffuse axonal injuries （DAI）. Methods：From Jan. 2007 to Oct. 2011,28 patients （12 hours after injury） with DAI were treated with calcium channel blocker, mild hypothermia, glucose control, antagonist for opioid receptors, prevention of stress ulcer, enteral and parenteral nutritional support, earlier period management to maintain the stability of respiratory and circulation system. Results： The prognosis of the patients was evaluated according to Glasgow Outcome Scale （GOS） six months after injury. Among the 28 cases,6 cases died, 6 persistent vegetative state ,5 severe disability,4 moderate disability,7 good recovery. Conclusions：The early period combined therapy can obviously reduce the mortalitv and the rate of deformitv in natients with DAI.

关 键 词：重型弥漫性轴索损伤 早期 集束化治疗 预后 

分 类 号：R651.15[医药卫生—外科学]