二次脑创伤临床诊断指标的初步探讨  

The Pirmary Ivestigation of the Clinical Standards of the Diagnosis with Secondary Index

作　　者：刘兴波[1] 衣服新[1] 罗俊生[1] 王秋华[1] 

机构地区：[1]锦州医学院附属医院神经外科,辽宁锦州121000

出　　处：《锦州医学院学报》2002年第3期1-3,共3页Journal of Jinzhou Medical College

基　　金：辽宁省教育厅课题 :总编号〔99172 15 89〕

摘　　要：目的　探讨二次脑创伤临床诊断指标。方法　随机选择 40例GCS3～ 8分颅脑损伤病人进行心电、体温、血压、血氧饱和度、氧分压、二氧化碳分压、颅内压、脑血流速度的连续监测 ,并记录GCS。结果　 40例病人中死亡 16例 ,各项指标变化多出现在伤后 18小时以后 ,主要变化指标为低血氧、高血压、颅内压增高、昏迷加重。这部分病人均有肺通、换气障碍 ,低血压 ,高热等因素 ,在颅内压明显增高之前均有低血氧 ,脑灌注过度的脑血流加快过程。结论　临床诊断二次脑创伤主要依据GCS及颅内压 ,并结合头颅CT检查结果。低血压、高热、低血氧。Objective To investigate the clinical standards of the diagnosis with secondary index. Methods 40 patients of severe brain injury with GCS 3～8 were randomized and observed.Electrocardiography,temperature,blood pressure,blood oxygen saturation,oxygen pressure,carbon diaoxygen pressure,intracranial pressure and blood flow velocity were monitored continuously. Results 16 of 40 paitents observed died.The changes of the various standards were low oxygen saturation,hypertension,intracranial pressure increasing and coma-intensfied compared with respiratory obstacle of lung,hypotension and high fever.Low blood oxygen and radical blood flow velocity increase of the cerebral perfusion pressure were found inevery patient. Conclusion The clinical diagnosic standards of secondary index were GCS and intracranial pressure combined with the result of head scanning.Hypotension,high fever and severe lung injury were the important relative factors.

关 键 词：脑损伤 颅内压 二次脑创伤 诊断 治疗 

分 类 号：R651.15[医药卫生—外科学]