颅脑损伤脑疝合并失血性休克急诊救治与影响因素.docVIP

颅脑损伤脑疝合并失血性休克急诊救治与影响因素 　　[摘要]目的 分析及判定颅脑损伤脑疝合并失血性休克的急诊救治与影响因素。方法 选取2015年2月～2016年1月我院收治的60例颅脑损伤脑疝合并失血性休克患者作为研究对象，依据其休克、脑疝等级予以不同方案的急救措施。分析及比较脑疝等级对治疗效果的影响。结果 60例患者中，死亡7例，其存活率为88.33%，治疗总有效率为70.00%。脑疝Ⅰ级患者的治疗总有效率高于Ⅱ、Ⅲ级脑疝患者，差异有统计学意义（P0.05）。Ⅰ级脑疝患者治疗后的S100B蛋白浓度及神经功能缺损评分均低于Ⅱ、Ⅲ级患者，差异有统计学意义（P0.05）。结论 脑疝等级、手术方式均会影响患者治疗后的临床疗效及预后情况，在手术措施正确且无差异时，脑疝等级是主要的影响因素，在临床中需要重视。 　　[关键词]格拉斯哥预后评分；颅脑损伤脑疝；失血性休克；生存率 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0026-03 　　Emergency treatment and influencing factors of craniocerebral hernia combined with hemorrhagic shock 　　XU Dong-sheng ZHANG Ye WANG Zhong-xiang▲ 　　Department of Emergency，101st Military Hospital of China，Jiangsu Province，Wuxi 214044，China 　　[Abstract] Objective To analyze and judge the emergency treatment and influencing factors of craniocerebral hernia combined with hemorrhagic shock.Methods From February 2015 to January 2016，60 patients with cerebral hernia combined with hemorrhagic shock treated in our hospital were selected as the research objects.The emergency measures of different schemes were given according to the grade of shock and cerebral hernia.The effect of cerebral herniation on therapeutic effect were analyzed and compared.Results Among the 60 patients，7 cases died，the survival rate was 88.33%，the total effective rate of treatment was 70.00%.The total effective treatment rate of patients with cerebral hernia levelⅠ was higher than level Ⅱ and Ⅲ，the differences was statistically significant （P0.05）.The S100B protein concentration and neural function defect scale of patients with cerebral hernia levelⅠafter treatment were lower than the patients with level Ⅱ and Ⅲ，the difference was statistically significant （P0.05）.Conclusion The cerebral hernia level and operation method will affect the clinical curative effect and prognosis of patients after treatment.When the operation procedure is correct and no difference is made，cerebral hernia level is the main influence factor，it needs attention in clinic. 　　[