摘要
目的:探讨早期使用激素治疗对重度颅脑损伤(sTBI)患者短期恢复及治疗的影响。方法:采取回顾性病例研究的方法,根据患者伤后1周以内是否使用GC治疗分为2组:GCs治疗组(66例)及非GCs治疗组(62例),按12天疗程自入院后第3天开始使用地塞米松,并严格按激素治疗标准逐步减量,所有病人治疗过程中密切观察神志、瞳孔、生命体征的变化,每日监测空腹+三餐后血糖及观察消化道是否有出血征象,伤后1d、3d、5d、7d、9d各复查头颅CT 1次,测量颅内最大处脑挫裂伤水肿最大径的变化情况,同时观察是否存在迟发出血以及观察是否需急诊开颅手术治疗;再利用统计软件对其具体数据进行统计分析。结果:两组患者的年龄、性别、致伤原因、入院时GCS、是否合并颅底骨折、是否合并SAH、脑挫裂伤形式以及是否合并消化道出血无明显差异。GCs治疗组比非GCs治疗组在脑挫裂伤水肿的控制以及开颅手术的发生上有较大改善,同时GCs治疗组的血糖水平相比较非GCs治疗组有明显上升。结论:GCs对sTBI早期控制水肿的治疗是有意义的,能有效减少开颅手术的几率。
Objective To investigate the effect of early hormone therapy on short-term recovery and treatment of severe craniocerebral injury(sTBI).Methods Retrospective case study was conducted,and patients were divided into two groups according to whether GC was used within 1 week after injury:GCs treatment group(66 cases)and the GCs treatment group(62 cases),according to the 12 days use dexamethasone therapy since 3 days after admission,and strictly according to standard hormone therapy reduced gradually,all closely observed during the process of patient care consciousness,pupil,the change of vital signs,daily monitoring+after meals on an empty stomach blood sugar and observe whether the digestive tract hemorrhage with signs,injury after 1 d,3 d,5 d,7 d,9 d the review head CT,maximize measuring intracranial cerebral contusion edema,changes of the maximum diameter,and observe whether there is any late sent blood and observe whether require emergency surgical operation treatment;Statistical software is used to analyze the specific data.Results There was no significant difference between the two groups in age,sex,cause of injury,GCS at admission,skull base fracture,SAH,brain contusion and gastrointestinal bleeding.Compared with the non-gcs treatment group,the control of cerebral contusion and laceration edema and the occurrence of craniotomy were significantly improved in the GCs treatment group,with significant statistical significance.Meanwhile,the blood glucose level in the GCs treatment group was significantly increased compared with the non-gcs treatment group,with statistical significance.Conclusion GCs is significant for the treatment of early sTBI edema control,and can effectively reduce the incidence of craniotomy.
作者
何佳宏
段继新
王承
He Jia-hong;Duan Ji-xin;Wang Cheng(Department of Neurosurgery,Changsha Hospital of Traditional Chinese Medicine,the Eighth Hospital of Changsha,Changsha 410100,China)
出处
《晓庄学院学报（医学版）》
2020年第6期100-103,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
糖皮质激素
创伤性颅脑损伤
非手术治疗
脑水肿
glucocorticoid
traumatic brain injury
non-surgical treatment
brain edema
