CAJ | 학술논문

目的：评估血清乳酸水平与颅脑损伤发生外伤性迟发性颅内血肿（DTIH）的关系。方法选择我院2012年6月-2015年1月收治的脑外伤患者160例，按 ISS 分值分成重伤组（16～25分）和严重伤组（≥25分），并根据预后分为 DTIH 组和非 DTIH 组。于入院时、6 h 和24 h 检测动脉血乳酸水平，计算乳酸清除率。结果严重伤组入院时、6 h、24 h 血乳酸水平及 DTIH 发生率均明显高于重伤组，差异均有统计学意义（P ＜0．05）；严重伤组12 h 乳酸清除率明显低于重伤组，差异有统计学意义（P ＜0．05）。DTIH 组入院时、6 h、24 h 血乳酸水平及 ISS 评分均明显高于非 DTIH 组，差异均有统计学意义（P ＜0．05）；DTIH 组6 h、12 h 乳酸清除率明显低于非 DTIH 组，差异均有统计学意义（P ＜0．05）。入院时、6 h、24 h 血乳酸水平与 DTIH 发生均呈正相关（P ＜0．05）。结论早期动脉血乳酸水平与颅脑损伤患者 DTIH 的发生密切相关，对评估颅脑损伤严重程度及判断 DTIH 发生风险具有重要意义。
목적：평고혈청유산수평여로뇌손상발생외상성지발성로내혈종（DTIH）적관계。방법선택아원2012년6월-2015년1월수치적뇌외상환자160례，안 ISS 분치분성중상조（16～25분）화엄중상조（≥25분），병근거예후분위 DTIH 조화비 DTIH 조。우입원시、6 h 화24 h 검측동맥혈유산수평，계산유산청제솔。결과엄중상조입원시、6 h、24 h 혈유산수평급 DTIH 발생솔균명현고우중상조，차이균유통계학의의（P ＜0．05）；엄중상조12 h 유산청제솔명현저우중상조，차이유통계학의의（P ＜0．05）。DTIH 조입원시、6 h、24 h 혈유산수평급 ISS 평분균명현고우비 DTIH 조，차이균유통계학의의（P ＜0．05）；DTIH 조6 h、12 h 유산청제솔명현저우비 DTIH 조，차이균유통계학의의（P ＜0．05）。입원시、6 h、24 h 혈유산수평여 DTIH 발생균정정상관（P ＜0．05）。결론조기동맥혈유산수평여로뇌손상환자 DTIH 적발생밀절상관，대평고로뇌손상엄중정도급판단 DTIH 발생풍험구유중요의의。
Objective To evaluate the correlation between serum lactic acid level and delayed traumatic intracranial hematoma (DTIH)in the patients of brain injury.Methods 160 patients of traumatic brain injury who were admitted into our hospital from 2012 June-2015 year in January were observed.according to ISS scores,they were divided into in-jury groups(16~ 25)and severe injury group(≥ 25),and according to the prognosis,they were divided into DTIH group and non DTIH group.Arterial blood lactate was measured at 0 h,6 h and 24 h,later 6 h and 24 h lactate clearance rate was calculated.Results 0 h,6 h,24 h serum lactic acid level and the incidence of DTIH in severe injury group were significantly higher than those in injury group,the differences were statistically significant (P <0.05);12h lactic acid clearance rate in severe injury group was significantly lower than that in injury group,the difference was statistically significant (P <0.05).0 h,6 h,24 h serum lactic acid level and ISS score in DTIH group were significantly higher than those in non DTIH group,the differences were statistically significant (P <0.05);6 h and 12 h lactic acid clearance rate in DTIH group was significantly lower than that in non DTIH group,the difference was statistically significant (P <0.05).There were significant correlation between 0h,6h,24h serum lactic acid level and DTIH (P <0.05).Conclusion There were significant correlation between early arterial blood lactate levels and DTIH in patients of traumatic brain injury,and it is important to evaluate the severity and risk of DTIH in patients of brain injury.