早期清除血性脑脊液在重型脑外伤治疗中的应用效果  

Application Effect of Early Removal of Bloody Cerebrospinal Fluid in the Treatment of Severe Traumatic Brain Injury

作　　者：韩桂保 徐杰 HAN Guibao;XU Jie(Department of Neurosurgery,Jinhu County Hospital of Traditional Chinese Medicine,Jinhu,Jiangsu Province,211600 China;Department of Neurosurgery,Jinhu County People's Hospital,Jinhu,Jiangsu Province,211600 China)

机构地区：[1]金湖县中医院神经外科,江苏金湖211600 [2]金湖县人民医院神经外科,江苏金湖211600

出　　处：《系统医学》2021年第23期109-112,共4页Systems Medicine

摘　　要：目的探讨早期清除血性脑脊液在重型脑外伤治疗中的应用效果。方法选取2017年6月—2021年5月金湖县中医院和金湖县人民医院收治的104例重型脑外伤患者,采用数字随机法将患者分为对照组(n=52)和观察组(n=52),两组患者均于术后接受常规治疗,观察组在常规治疗基础上增加早期清除血性脑脊液治疗。对比两组住院时间、格拉斯哥昏迷指数(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、皮质醇(Cor)水平、甲肾上腺素(NE)水平、简明健康调查量表(SF-36)评分。结果观察组住院时间(18.46±5.37)d明显短于对照组(24.72±7.44)d,差异有统计学意义(t=4.920,P<0.001)。术前两组GCS、NIHSS评分比较,差异无统计学意义(t=0.710、0.071,P=0.479、0.944);术后、术后4周两组患者GCS、NIHSS评分均有改善,且观察组(4.42±0.24)分、(40.92±3.52)分均优于对照组(4.15±0.33)分、(43.35±4.64)分,差异有统计学意义(t=4.772、3.009,P<0.005)。术前,两组Cor、NE水平比较,差异无统计学意义(t=0.153、0.155,P=0.879、0.877);术后,两组Cor、NE水平均有所下降,且观察组(284.44±60.24)ng/mL,(687.92±65.52)pg/mL均比对照组(314.15±61.23)ng/mL,(723.35±74.64)pg/mL低,差异有统计学意义(t=2.494、2.572,P=0.014、0.012)。术后4周,观察组患者生活质量(74.15±7.33)分比对照组(66.42±7.24)分高,差异有统计学意义(t=5.410,P<0.001)。结论早期清除血性脑脊液应用于重型脑外伤治疗的患者,可缩短患者住院时间,促进神经功能恢复,降低应激性指标,提高患者的生活质量,值得推广使用。Objective To investigate the effect of early removal of blood cerebrospinal fluid in the treatment of severe traumatic brain injury.Methods From June 2017 to May 2021,104 patients with severe traumatic brain injury admitted to Jinhu County Hospital of Traditional Chinese Medicine and Jinhu County People’s Hospital were selected,and the patients were divided into control group(n=52)and observation group(n=52)by numerical randomization.Both groups of patients received conventional treatment after surgery,and the observation group added early treatment for clearing blood cerebrospinal fluid on the basis of conventional treatment.The length of hospital stay,Glasgow Coma Index(GCS)score,National Institutes of Health Stroke Scale(NIHSS)score,cortisol(Cor)level,norepinephrine(NE)level,and Simplified Health Survey Scale(SF-36)Scoring.Results The length of stay in the observation group(18.46±5.37)d was significantly shorter than that of the control group(24.72±7.44)d,the difference was statistically significant(t=4.920,P<0.001);there was no statistically significant difference in the GCS and NIHSS scores between the two groups before operation(t=0.710,0.071,P=0.479,0.944),the GCS score and NIHSS score of the two groups of patients improved after operation and 4 weeks after operation,and the observation group(4.42±0.24)points,(40.92±3.52)points was better than the control group(4.15±0.33)points,(43.35±4.64)points,the difference was statistically significant(t=4.772,3.009,P<0.05);before surgery,there was no statistically significant difference in the levels of Cor and NE between the two groups(t=0.153,0.155,P=0.879,0.877);after the operation,the levels of Cor and NE in the two groups decreased,and the observation group(284.44±60.24)ng/mL,(687.92±65.52)pg/mL was lower than the control group(314.15±61.23)ng/mL,(723.35±74.64)pg/mL,the difference was statistically significant(t=2.494,2.572,P=0.014,0.012).4 weeks after operation,the quality of life(74.15±7.33)points of the observation group was higher than that of t

关 键 词：早期清除血性脑脊液 重型脑外伤 GCS NIHSS COR NE 

分 类 号：R651[医药卫生—外科学]