CAJ | 학술논문

目的：探讨重型颅脑损伤后脑疝合并失血性休克的早期救治策略及其对预后的影响。方法选择重型颅脑损伤后脑疝合并休克患者252例，按随机数字表法分为观察组和对照组，每组126例，分别采用早期救治策略和传统救治模式两种方式，对早期救治策略的优点及其对预后的影响进行分析。结果治疗后，观察组病死率为34．13％，对照组病死率为48．41％，两组差异有统计学意义（χ2＝5．306，P＝0．021）；损伤后6个月随访结果，观察组轻度及中度伤残患者比例为56．35％（71/126），对照组为35．71％（45/126），观察组重度伤残及植物生存状态、死亡患者的比例为43．65％（55/126），对照组为64．29％（81/126），两组差异有统计学意义（χ2＝5．306，P＝0．001）。结论对重型颅脑损伤后脑疝合并失血性休克的患者采取一系列的早期救治策略，患者病死率明显降低，预后GOS伤残评级显著降低。
목적：탐토중형로뇌손상후뇌산합병실혈성휴극적조기구치책략급기대예후적영향。방법선택중형로뇌손상후뇌산합병휴극환자252례，안수궤수자표법분위관찰조화대조조，매조126례，분별채용조기구치책략화전통구치모식량충방식，대조기구치책략적우점급기대예후적영향진행분석。결과치료후，관찰조병사솔위34．13％，대조조병사솔위48．41％，량조차이유통계학의의（χ2＝5．306，P＝0．021）；손상후6개월수방결과，관찰조경도급중도상잔환자비례위56．35％（71/126），대조조위35．71％（45/126），관찰조중도상잔급식물생존상태、사망환자적비례위43．65％（55/126），대조조위64．29％（81/126），량조차이유통계학의의（χ2＝5．306，P＝0．001）。결론대중형로뇌손상후뇌산합병실혈성휴극적환자채취일계렬적조기구치책략，환자병사솔명현강저，예후GOS상잔평급현저강저。
Objective To study early treatment strategy for brain hernia combined with hemorrhagic shock and the effect on prognosis of patients with severe head injury.Methods 252 cases of patients with severe head inju-ry and brain hernia combined with hemorrhagic shock in the mergency intensive care unit were divided into the obser-vation group and control group according to the stochastic indicator method,each group in 126 cases.The two group were treated with early treatment strategy and traditional treatment mode,respectively.The advantages and effect of two modes were analyzed.Results The majority of patients had united injury,such as soft tissue injuries,pelvis and spine fractures.There were 136 cases of patients with mild brain hernia and the rate of patients with hemorrhagic shock was 62.30%(157/252).The mortality was 34.13% in the observation group and 48.41% in the control group.There was significant difference(χ2 =5.306,P=0.021).The ratio of patinents with mild disability was 56.35%(71/126) in the observation group and the control group was 35.71%(45/126).The severe disability,vegetative state and death was 43.65%(55/126) in the observation group after the follow-up of 6 months.It was significantly lower than that of the control group(χ2 =5.306,P=0.001).Conclusion The early strategy treatment has a positive effect on reducing the mortality of brain hernia combined with hemorrhagic shock of patients with severe head injury the GOS for the prognosis disability increases significantly.