重型颅脑外伤患者早期血压变异性与近期预后关系分析.docVIP

重型颅脑外伤患者早期血压变异性与近期预后关系分析 　　[摘要] 目的 探讨重型颅脑外伤患者早期血压变异性与近期预后的关系。方法 随机选取2013年1月―2016年1月两院收治的100例GCS评分为3～8分的重型颅脑外伤患者为研究对象，观察伤后72 h内患者血压参数和变异系数。随访6个月，依患者GOS评分将入选病例均为两组。实验组50例，患者GOS评分1～3分；对照组50例，患者GOS评分4～5分，分析影响严重颅脑外伤患者预后的血压变异性因素。结果 实验组72 h SBP-SD（9.3±2.2）mmHg， SBP-CV（0.05±0.01），对照组72 h SBP-SD（17.4±6.0）mmHg，SBP-CV（0.18±0.03），组间比较差异有统计学意义（P0.05）。结论 重型颅脑外伤患者伤后72 h内收缩压血压标准差和变异系数过高是影响近期预后的危险因素。 　　[关键词] 重型颅脑外伤；血压变异性；近期预后 　　[中图分类号] R651 [文献标识码] A [文章编号] 1674-0742（2017）02（b）-0039-03 　　[Abstract] Objective To discuss the correlation between the early blood pressure variability and short-term prognosis of patients with severe craniocerebral injury. Methods Random selection 100 cases patients with severe craniocerebral injury whose GCS score was 3 to 8 admitted and treated in our hospital from January 2013 to January 2016 were selected as the research objects and the blood pressure parameters and variability coefficient of patients within 72h after wound were observed， and after 6-month follow-up， and the selected cases were divided into two groups with 50 cases in each according to the GOS score， the GOS score in the experimental group was 1 to 3 marks， and the GOS score in the control group was 4 to 5， and the blood pressure variability factors after prognosis of patients with severe craniocerebral injury were analyzed. Results The differences in the 72 h SBP-SD and SBP-CV between the experimental group and the control group had statistical significance by comparison[（9.3±2.2）mmHg， （0.05±0.01） vs （17.4±6.0）mmHg， （0.18±0.03）]（P0.05）. Conclusion The exorbitant systolic pressure blood pressure standard deviation within 72h after wound and variability coefficient of patients with severe craniocerebral injury is the risk factors of short-term prognosis. 　　[Key words] Severe craniocerebral injury； Blood pressure variability； Short-term prognosis 　　重型?B脑外伤是创伤性脑损伤中最为严重的一种，其病情急重、表现复杂、颅内压增高迅速，短期内即可造成神经系统功能障碍或继发脑死亡，是致死、致残的主要原因，需要临床早期正确干预治疗，以改善预后，降低死亡率[1]。近年研究发现，血压对颅内压、脑血流量等指标具有直接影响，与重