CAJ | 학술논문

目的：观察早期腰大池持续引流联合硫酸镁治疗弥漫性轴索损伤的临床疗效。方法将弥漫性轴索损伤患者84例随机分成联合治疗组和常规治疗组，每组42例。常规治疗组予保持呼吸道通畅，早期静脉应用尼莫同，神经节苷脂及纳洛酮，降低颅内压、改善微循环，维持水电解质、酸碱平衡及营养支持处理，病情稳定后进行高压氧、针灸及理疗等康复治疗。联合治疗组在常规治疗的基础上加用早期腰大池持续引流10～14d，联合25％硫酸镁（用量按0．3～0．4ml· kg－1· d－1计算）缓慢静脉滴注，治疗7～10d。观察两组患者治疗效果。结果两组比较，联合治疗组患者恢复良好率、病床周转率明显高于常规治疗组；气管切开、肺部感染、住院天数及住院费用四项明显低于常规治疗组，以上差异均有统计学意义（ P＜0．05）。结论该方法明显优于传统治疗方法，疗效肯定，可促进神经功能恢复，改善患者预后，有效降低肺部感染和气管切开的发生率，减少患者住院天数及住院费用，缩短病程，值得在临床工作中推广使用。
목적：관찰조기요대지지속인류연합류산미치료미만성축색손상적림상료효。방법장미만성축색손상환자84례수궤분성연합치료조화상규치료조，매조42례。상규치료조여보지호흡도통창，조기정맥응용니막동，신경절감지급납락동，강저로내압、개선미순배，유지수전해질、산감평형급영양지지처리，병정은정후진행고압양、침구급리료등강복치료。연합치료조재상규치료적기출상가용조기요대지지속인류10～14d，연합25％류산미（용량안0．3～0．4ml· kg－1· d－1계산）완만정맥적주，치료7～10d。관찰량조환자치료효과。결과량조비교，연합치료조환자회복량호솔、병상주전솔명현고우상규치료조；기관절개、폐부감염、주원천수급주원비용사항명현저우상규치료조，이상차이균유통계학의의（ P＜0．05）。결론해방법명현우우전통치료방법，료효긍정，가촉진신경공능회복，개선환자예후，유효강저폐부감염화기관절개적발생솔，감소환자주원천수급주원비용，축단병정，치득재림상공작중추엄사용。
Objective To assess the clinical efficacy of continued lumbar cerebrospinal fluid drainage ( CLCFD) early combined with magnesium sulfate on diffuse axonal injury ( DAI) .Methods 42 cases of DAI were randomly divided into combined treatment group and conventional treatment group, 42 cases respectively.The patients from conventional treatment group were kept air way unobstructed, nimotop,ganglioside and naloxone were intravenous applied early, reduced intra-cranial pressure,micro-circulation was improved, maintained the balance of water and electrolyte, as well as acid-base balance, nutritional support, and so on.Rehabilitation treatments such as hyperbaric oxygen, acupuncture and physical therapy were used after the condition became stable.On the basis of conventional treatment, the patients from combined treatment group were added CLCFD early for 10-14 days, combined with 25%magnesium sulfate (dosage by 0.3-0.4ml· kg-1· d-1 calculation) slow quiet drop for the treatment of 7-10 days. The treatment effect of the two groups were compared.Results The better recovery rate and bed turnover rate of combined treatment group were higher and the cut open, pulmonary infection, hospital stay, and hospitalization expenses were lower than that of the conventional treatment group .The differences were statistically significant ( P<0.05) .There were no statistically significant differences between the complications and comparison of the results of the follow-up of the two groups (P>0.05).Conclusion This method is obviously superior to the traditional treatment method, the curative effect is certain.It can promote the recovery of nerve function, improve the prognosis of the patients, effectively reduce the pulmonary infection, incidence of tracheotomy and reduce length of hospital stay and hospital costs, shorten the course of disease, reduce the cost of nursing staff, improve the turnover rate of hospital beds, increase the economic benefits and social benefits of the hospital, which is worthy of promotion and application in clinical work.