论文部分内容阅读
目的探讨重型颅脑创伤并发神经源性肺水肿(NPE)患者的临床特点和治疗方法。方法回顾性分析我院2001年10月—2009年10月收治的所有颅脑创伤患者812例,依据患者是否并发NPE分为两组,NPE组12例,非NPE组800例。收集所有患者临床资料以及格拉斯格评分(GCS)。结果颅脑创伤患者共812例,其中并发NPE者12例,并发症率为1.48%。两组患者年龄比较,差异无统计学意义(P>0.05);而两组患者性别构成、GCS评分、病死率比较,差异均有统计学意义(P<0.05)。NPE组患者的治疗:去除原发病因,积极降低颅内压,机械通气,早期行气管切开术,氧疗,吗啡,肾上腺糖皮质激素及扩张血管药物等综合治疗。结论重型颅脑创伤并发NPE患者以男性、GCS评分低者高发,病死率高,早期诊断和治疗对改善患者预后尤为重要。
Objective To investigate the clinical features and treatment of patients with severe traumatic brain injury complicated with neurogenic pulmonary edema (NPE). Methods A retrospective analysis of 812 cases of all traumatic brain injury admitted to our hospital from October 2001 to October 2009 was performed. Patients were divided into two groups according to whether NPE was complicated or not, 12 in NPE group and 800 in non-NPE group. All patient clinical data were collected along with the Glasgow score (GCS). Results A total of 812 patients with traumatic brain injury, of which 12 cases were complicated with NPE, the complication rate was 1.48%. There was no significant difference in age between the two groups (P> 0.05). There was significant difference in gender composition, GCS score and mortality between the two groups (P <0.05). NPE group of patients treatment: removal of the primary cause, and actively reduce intracranial pressure, mechanical ventilation, early tracheotomy, oxygen therapy, morphine, adrenal glucocorticoid and dilation of vascular drugs and other comprehensive treatment. Conclusions Severe craniocerebral trauma patients with NPE are male and have lower GCS score. The mortality rate is high. Early diagnosis and treatment are particularly important to improve the prognosis of patients.