脑外伤患者意识障碍的评估对其预后的影响

目的通过分析脑外伤患者的意识障碍程度的判断与其预后的相关性,明确在病程中正确评估患者意识状态的重要性。方法回顾分析2005年4月至2010年1月因急性颅脑损伤出现意识障碍住院患者的临床资料317例,入院时格拉斯哥昏迷评分（GCS）评分9～12分85例,GCS〈8分者232例;开颅手术214例,保守治疗103例。结果按GOS结果分级评定：Ⅴ级205例,Ⅳ级37例,Ⅲ级9例,Ⅱ级3例,Ⅰ级63例。GCS评分〈8分组的病死率明显高于GCS评分9～12分组,差异有显著统计学意义（χ^2=21.76,P〈0.01）,痊愈率低于GCS评分9～12组,差异有统计学意义（χ^2=4.56,P〈0.05）。结论正确评估脑外伤患者的意识障碍的程度对患者的预后有着积极的意义。

Study on evaluation of conscious disturbance in patients with cerebral trauma and its influence on prognosis

Objective To analyze the judgment on degree of conscious disturbance in patients with cerebral trauma and the relationship with its prognosis,and to clarify the importance of correct judgment on conscious state of patients during the course of disease.Methods The clinical data of 317 patients with head injury and conscious disturbance during April 2005 to January 2010 were retrospectively reviewed and analyzed.Among them,85 cases were 9-12 points in GCS evaluation and 232 cases with GCS8.214 of them received craniotomy and 103 cases received conservative treatment.Results According to the classification of GOS,205 cases were in level V,37 case in level IV,9 cases in level III,3 cases in level II and 63 cases in level I.It is obvious that the mortality rate of patients with GCS8 is higher than that of patients with GCS 9-12,which is statistically more significant（χ^2= 21.76,P0.01）,the rate of healing is lower than that of GCS 9~12,which is statistically significant（χ^2= 4.56,P0.05）.Conclusion Correct judgment on conscious states has positive effect on prognosis of these patients.