rSIG与动脉血乳酸对重型颅脑创伤患者预后评估的价值

目的探讨rSIG(the reverse shock index multiplied by Glasgow coma scale score)与动脉血乳酸(Lac)对重型颅脑创伤患者预后评估的价值。方法回顾性分析某院急诊抢救室2016年8月至2019年9月收治的120例重型颅脑创伤患者的临床资料,以外伤后28 d预后情况为标准,将患者分为生存组(81例)和死亡组(39例)。比较两组患者的临床资料;分析影响重型颅脑创伤患者死亡的危险因素;分析rSIG与动脉血Lac及两者联合对重型颅脑创伤患者预后的预测价值。结果存活组的收缩压、舒张压、平均动脉压、GCS评分及rSIG均明显高于死亡组,动脉血Lac水平明显低于死亡组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,收缩压、GCS评分、rSIG、动脉血Lac是重型颅脑创伤患者死亡的独立危险因素(P<0.05)。rSIG联合动脉血Lac对重型颅脑创伤患者死亡率的预测能力优于rSIG(P<0.05),但与动脉血Lac比较(P>0.05)。结论rSIG、动脉血Lac是重型颅脑创伤患者预后相关的独立危险因素,且对重型颅脑创伤患者伤情严重程度及预后有较好的预测价值。

Value of rSIG and arterial blood lactic acid in evaluating the prognosis of patients with severe traumatic brain injury

Objective To explore the value of rSIG(the reverse shock index multiplied by Glasgow coma scale score)and arterial blood lactic acid(Lac)in evaluating the prognosis of patients with severe traumatic brain injury.Methods The clinical data of 120 patients with severe traumatic brain injury admitted in the emergency room of the hospital from August 2016 to September 2019 were retrospectively analyzed,the prognosis of 28 d after trauma was the standard,and the patients were divided into survival group(81 cases)and death group(39 cases).The clinical data of the two groups were compared;the risk factors of death in patients with severe traumatic brain injury were analyzed;the predictive value of rSIG,arterial blood Lac and their combination on the prognosis of patients with severe traumatic brain injury was analyzed.Results Systolic blood pressure,diastolic blood pressure,mean arterial pressure,GCS score and rSIG of the survival group were significantly higher than those of the death group,and the level of arterial blood Lac was significantly lower than that of the death group(P<0.05).Multivariate Logistic regression analysis showed that systolic blood pressure,GCS score,rSIG,arterial blood Lac were independent risk factors of death in patients with severe traumatic brain injury(P<0.05).The predictive ability of the rSIG combined with arterial blood Lac was better than rSIG(P<0.05),but there was no significant difference compared with arterial blood Lac(P>0.05).Conclusion The rSIG and arterial blood Lac are independent risk factors related to the prognosis of patients with severe traumatic brain injury,and have a good predictive value for the severity and prognosis of patients with severe traumatic brain injury.