弥漫性轴索损伤的特点及救治经验

目的 探讨弥温性轴索损伤患者的临床表现、治疗方法及预后。方法 70例弥漫性轴索损伤的患者均行CT或MRI检查、颅内压监控、血糖监测，其中40例给予亚低温治疗，其余患者给予常规治疗（作为对照组）；全部患者3个月后行格拉斯哥预后评分判断预后。结果 70例患者不同程度出现意识障碍、颅内压增高、血糖增高，MRI较CT具有更高的诊断率，亚低温治疗组血糖、颅内压较对照组明显降低（P＜0．05或P＜0．01）。结论 MRI有利于弥漫性轴索损伤的诊断，亚低温治疗可以有效地降低死亡率，改善预后。

Clinical experience of treatment for acute diffuse axonal injury

Objective To study the clinical features, therapies and prognosis of acute diffuse axonal injury (DAI).Methods Seventy patients with DAI were diagnosed by CT or MRI scan, intracranial pressure (ICP) and blood glucose were measured. 40 cases were treated by mild hypothermia and the remaining by routine therapy as control group. According to Glasgow Outcome Scale (GOS), the prognosis of the patients was evaluated 3 months later.Results All the patients suffered from unconsciousness, high ICP and blood glucose. MRI scan had a higher diagnosis rate than CT scan on DAI. Compared with the control group, mild hypothermia significantly decreased high ICP and raised blood glucose ( P < 0.05 or P < 0.01 ).Conclusion MRI scan is an effective method in diagnosing DAI. Mild hypothermia can reduce the mortality and improve the prognosis.