脑外伤心肺损害

目的:探讨脑外伤所致心肺损害的临床表现及预后。方法:连续收集149例脑伤伴发心肺损害的临床资料,根据损伤部位不同分为脑心组132例,脑肺组12例,心肺组5例,并分析3组的临床表现和预后,进一步比较脑心组、脑肺组中不同表现的亚组的死亡率。结果:心电图异常88.6%(132/149),神经源性肺水肿8.1%(12/149),同时具有心电图异常和神经源性肺水肿者3.4%(5/149)。脑心组、脑肺组及心肺组入院GCS评分分别为(8.2±2.9)、(6.3±1.4)及(6.2±1.3)分,脑心组与脑肺组(P=0.046)、脑心组与心肺组(P=0.039)比较GCS评分差异具有统计学意义。脑心组、脑肺组及心肺组死亡率分别为4.5%(6/132)、41.7%(5/12)及60.0%(3/5),脑心组与脑肺组(P=0.001)、脑心组与心肺组(P=0.002)比较死亡率差异具有统计学意义。重度肺水肿和轻度肺水肿比较,死亡率差异有统计学意义(P=0.015)。结论:脑外伤心肺损害使伤情进一步加重,严重影响预后,临床工作中应重视脑外伤心肺损害的预防与治疗。

Heart and lung damage caused by cerebral trauma

Objective： To investigate clinical manifestations and prognosis of heart and lung damage caused by cerebral trauma. Methods： Data of 149 patients with heart and lung damage caused by cerebral trauma were collected. They were randomly divided into brain heart group （BHG） （132 cases）, brain-lung group（BLG） （12 cases） and heart-lung group （HLG） （5 cases）. Clinical manifestations and prognosis were analyzed, the mortality of the subgroups of BHG and BI.G was compared. Results： There were 132 patients with electrocardiogram abnormalitics（ECGA）（88.6%）, 12 patients with neurogenic pulmonary edema（NPE） （8. 1%）, and 5 patients with ECGA and NPE both（3. 4%）. The admission GCS score of BHG, BLG and HLG were （8.2±2.9）,（6.34±1.4） and （6. 2±1.3） , respectively, and the differences between BHG and BLG（P=0.046）, BHG and HLG（P=0. 039）, were statistically significantly. The mortality of BHG, BLG and HLG were 4.5%, 41.7% and 60.0%, respectively, and the differences between BHG and BLG（P=0.001）, BHG and HLG（P=0.002）, were also statistically significantly. The difference of mortality between patients with severe pulmonary edema and mild pulmonary edema was statistically significantly（P=0.015）. Oonclusions： Heart and lung damage due to cerebral trauma aggravates the injury and seriously affects the prognosis. It should pay attention to the prevention and treatment.