重型弥漫性轴索损伤早期处理对策

目的探讨重型弥漫性轴索损伤(DAI)早期处理对策。方法对1998年1月~2005年8月收治的重度弥漫性轴索损伤患者于伤后12 h内,给予钙离子拮抗剂、亚低温治疗、控制血糖、阿片受体拮抗剂应用、防止应激性溃疡、肠内外营养支持以及合并伤早期处理,维持呼吸循环稳定。结果伤后6个月按GOS统计,其中死亡8例,植物生存6例,重残8例,中残12例,良好8例。结论对重型DAI早期综合治疗(12 h内)可明显降低患者的死亡率和致残率。

Early therapy strategy on patients with diffuse axonal injuries

Aim To discuss the early treatment of the patients with diffuse axonal injuries(DAI).Methods Within 12 hours after injury all the patients with DAI hospitalized from January,1998 to Aug,2005 were treated with calcium channel blocker,mild hypothermia,glucose control,antagonist for opioid receptors,prevention of stress ulcer,parenteral nutrition and enteral nutrition,earlier period management to associated injury and maintain the stability of respiratory and circulation system.Results The prognosis of the patients was evaluated according to Glasgow Outcome Scale(GOS) six months after injury.Of 42 patients with DAI,8 cases were dead,6 persistent vegetative state,8 severe disability,12 moderate disability,8 good recovery.Conclusion The early period combined therapy can obviously reduce the mortality and the rate of deformity in patients with DAI.