摘要
目的观察运用隆德概念治疗重型颅脑损伤患者的临床效果。方法选取2022年8月—2023年10月柳州市人民医院重症医学科收治的50例重型颅脑损伤患者,采用随机数字表法分为对照组和观察组,每组25例。对照组采用常规治疗方法,观察组在常规治疗基础上运用隆德概念治疗。观察两组患者入ICU时及入ICU后24 h、3 d、7 d、14 d脑脊液白细胞介素-6(IL-6)水平、脑水肿CT评估量、颅内压(ICP)以及治疗前后格拉斯哥昏迷评分(GCS)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、ICU停留时间及3个月后格拉斯哥预后评分(GOS)。结果与入ICU时相比,入ICU后24 h、3 d、7 d、14 d两组患者脑脊液IL-6水平、脑水肿CT评估量及ICP均不同程度升高;入ICU后24 h、3 d,观察组脑脊液IL-6水平、CT评估量低于对照组;入ICU后7 d,观察组脑脊液IL-6水平、脑水肿CT评估量及ICP低于对照组;入ICU后14 d,观察组ICP低于对照组,差异均有统计学意义(P<0.05)。治疗后,GCS评分高于对照组、APACHEⅡ评分低于对照组,ICU停留时间短于对照组,GOS预后良好率高于对照组,差异均有统计学意义(P<0.05)。结论隆德概念可以有效减少重型颅脑损伤患者脑脊液IL-6,控制伤后炎症反应,减轻继发性脑水肿,降低ICP,改善预后。
Objective To observe the clinical effect of Lund concept in the treatment of patients with severe craniocerebral injury.Methods A total of 50 patients with severe craniocerebral injury admitted to the Department of Intensive Care Medicine in Liuzhou People's Hospital from August 2022 to October 2023 were selected and divided into control group and observation group by random number table method,with 25 cases in each group.The control group received conventional treatment,while the observation group received the Lund concept treatment on the basis of conventional treatment.The levels of cerebrospinal fluid interleukin-6(IL-6),CT assessment of cerebral edema,and intracranial pressure(ICP)at the time of ICU admission,and after admission for 24 h,3 d,7 d,and 14 d were observed,and values of Glasgow Coma Score(GCS),Acute Physiology and Chronic Health EvaluationⅡ(APACHE-II)score before and after treatment,ICU stay duration,and Glasgow Outcome Score(GOS)after treatment for 3 months were also observed.Results The levels of IL-6 in cerebrospinal fluid,CT assessment of cerebral edema and ICP after admission for 24 h,3 d,7 d,14 d were increased to different degrees after injury in the two groups compared with the time of ICU admission,the values of IL-6 and CT evaluation of cerebrospinal fluid after admission for 24 h and 3 d in the observation group were lower than those in the control group;the levels of IL-6 in cerebrospinal fluid,CT assessment of brain edema and ICP after admission for 7 d in the observation group were lower than those in the control group;the ICP level after admission for 14 d in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment in the observation group,the GCS score and the good prognosis rate of GOS were higher than those in the control group,while the APACHE-II score and ICU stay duration were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Lund concept can effectively reduce the level of cerebrospinal fluid IL-6,control the inflammatory reaction after injury,reduce secondary brain edema and ICP,and improve prognosis in patients with severe craniocerebral injury.
作者
张磊
覃月佳
黄典
江淇
ZHANG Lei;QIN Yuejia;HUANG Dian;JIANG Qi(Department of Intensive Care Medicine,Liuzhou People's Hospital,Liuzhou,Guangxi 545006,China)
出处
《医药前沿》
2025年第2期1-5,共5页
Journal of Frontiers of Medicine
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-B20221299)。
