CAJ | 학술논문

目的探讨脑创伤(TBI)长期意识障碍患者脑干反射(BSR)表现与清醒预后的关系.方法记录自2010年3月至2011年6月南方医科大学珠江医院神经外科收治的60例重型TBI后意识障碍超过2周患者的BSR表现.以TBI后6个月患者是否清醒为标准,分为清醒组与未清醒组,两组间运用独立样本x2检验筛选出有意义的指标. 结果 60例重型TBI患者6个月内清醒36例,清醒率为60.0％.BSR的异常概率为23.8％,BSR中左侧睫脊反射,左侧垂直性眼前庭反射,双侧瞳孔对光反射以及双侧眼心反射出现阴性的表现在清醒与未清醒组间差异差异有统计学意义(P＜0.05),上述BSR异常时患者的未清醒率较高. 结论 BSR的表现可客观、准确地反映TBI长期意识障碍患者的脑损伤程度并对患者的清醒结果进行预测.
목적 탐토뇌창상(TBI)장기의식장애환자뇌간반사(BSR)표현여청성예후적관계.방법 기록자2010년3월지2011년6월남방의과대학주강의원신경외과수치적60례중형TBI후의식장애초과2주환자적BSR표현.이TBI후6개월환자시부청성위표준,분위청성조여미청성조,량조간운용독립양본x2검험사선출유의의적지표. 결과 60례중형TBI환자6개월내청성36례,청성솔위60.0％.BSR적이상개솔위23.8％,BSR중좌측첩척반사,좌측수직성안전정반사,쌍측동공대광반사이급쌍측안심반사출현음성적표현재청성여미청성조간차이차이유통계학의의(P＜0.05),상술BSR이상시환자적미청성솔교고. 결론 BSR적표현가객관、준학지반영TBI장기의식장애환자적뇌손상정도병대환자적청성결과진행예측.
Objective To explore the correlation between the findings ofbrainstem reflex (BSR)and the prognosis of consciousness in long-term unconscious patients with severe traumatic brain injury (TBI).Methods BSR findings were collected in 60 patients,admitted to our hospital from March 2010 to June 2011 and suffered from severe TBI with a duration of disturbance of consciousness≥2weeks.The patients were divided into conscious and unconscious groups based on whether or not the patients were still with disturbance of consciousness 6 months after the injury.And finally,the significant indicators were chosen in the two groups using chi square test.Results A total of 36 patients (60.0％)retrieved consciousness 6 months after the injury.The abnormality rate of BSR was 23.8％.Significant differences were noted between conscious and unconscious groups in the disappearance of left ciliospinal reflex,left vertical oculo-vestibular reflex,double light reflex and oculocardiac reflex.The unconscious probabilities in patients with abnormal BSR which indexes mentioned above were higher.Conclusion The findings of BSR can objectively and accurately demonstrate the degree of cerebral dysfunction and predict the prognosis of consciousness.