CAJ | 학술논문

目的：探讨黄体酮（PG）联合维生素D对重型颅脑损伤的治疗价值。方法将98例急性重型颅脑损伤患者按随机数字表法分为PG联合维生素D治疗组（34例），单用PG治疗组（31例）及对照组（33例），比较3组患者治疗后格拉斯哥昏迷评分（GCS）、患者住院期间感染率和病死率、伤后3个月格拉斯哥预后评分（GOS）及预后良好率的差异。结果患者治疗2周的GCS评分PG治疗组与对照组比较差异有统计学意义（P＜0.05），而患者病死率、感染率、伤后3个月GOS评分、伤后3个月预后良好率等方面差异均无统计学意义（均P＞0.05），而PG+维生素D治疗组与其他两组患者伤后2周GCS评分、伤后3个月GOS评分和预后良好率等方面差异均有统计学意义（均P＜0.05），感染率和总体病死率与其他两组差异均无统计学意义（均P＞0.05），但在极重度颅脑损伤（GCS评分3~5分）患者中，与对照组相比，两者的病死率差异有统计学意义（P＜0.05）。结论应用PG联合维生素D治疗急性重型颅脑损伤，可以降低颅脑外伤患者伤后的病死率，促进患者神经功能康复，改善患者的预后。
목적：탐토황체동（PG）연합유생소D대중형로뇌손상적치료개치。방법장98례급성중형로뇌손상환자안수궤수자표법분위PG연합유생소D치료조（34례），단용PG치료조（31례）급대조조（33례），비교3조환자치료후격랍사가혼미평분（GCS）、환자주원기간감염솔화병사솔、상후3개월격랍사가예후평분（GOS）급예후량호솔적차이。결과환자치료2주적GCS평분PG치료조여대조조비교차이유통계학의의（P＜0.05），이환자병사솔、감염솔、상후3개월GOS평분、상후3개월예후량호솔등방면차이균무통계학의의（균P＞0.05），이PG+유생소D치료조여기타량조환자상후2주GCS평분、상후3개월GOS평분화예후량호솔등방면차이균유통계학의의（균P＜0.05），감염솔화총체병사솔여기타량조차이균무통계학의의（균P＞0.05），단재겁중도로뇌손상（GCS평분3~5분）환자중，여대조조상비，량자적병사솔차이유통계학의의（P＜0.05）。결론응용PG연합유생소D치료급성중형로뇌손상，가이강저로뇌외상환자상후적병사솔，촉진환자신경공능강복，개선환자적예후。
Objective To evaluate the effect of progesterone (PG) and vitamin D(VD) on the patients with severe brain trauma. Methods 98 patients with acute severe brain injury were randomly assigned into 3 groups:PG+VD group (n=34), PG group (n=31), and control group (n=33). GCS(Glasgow coma scale) 2 weeks after injury, infection rate and mortality during hos-pitalization, GOS (Glasgow outcome scale) and rate of favorable prognosis after three months were compared among these groups. Results There was significant difference in GCS between the PG group and control group after two weeks' treatment (P<0.05), while there were no statistical differences in the infection rate and mortality during hospitalization, GOS and rate of fa-vorable prognosis three months after injury (alP>0.05). There were significant differences in GCS two weeks after injury, GOS and rate of favorable prognosis in PG+VD group and the other two groups (al P<0.05), but no significant differences in infection rate and overal mortality (alP>0.05). However, there were statistical differences in mortality between PG+VD group and control group in extremely severe brain injury (GCS=3~5) patients P<0.05). Conclusion The use of PG and VD in severe brain injury treatment can decrease the mortality, promote the neurological function rehabilitation and improve patients' prognosis.