摘要
目的 探讨采用Lund概念提出的新型治疗方法能否降低严重颅脑损伤患者的病死率.方法 将68例格拉斯哥昏迷评分（GCS）3～8分的严重颅脑损伤患者按照随机原则分为对照组（38例）和Lund组（30例）.对照组以常规治疗方法控制颅内压（ICP）;Lund组采用Lund概念提供的治疗措施,术后5 d连续监测ICP、脑灌注压（CPP）.结果 Lund组5 d甘露醇用量（g）较对照组明显减少（139.6±25.0比587.5±31.8,P＜0.01）;Lund组28 d病死率显著低于对照组（30.0%比57.9%,P＜0.05）.Lund组中死亡者（9例）ICP＞25 mm Hg（1 mm Hg=0.133 kPa）、ICP＞35 mm Hg、CPP＜50 mm Hg的比例显著高于生存者[21例,分别为（45.0±23.2）%比（7.2±3.6）%,（40.2±18.6）%比（2.2±1.6）%,（35.9±12.9）%比（3.1±2.4）%,均P＜0.05].结论 采用Lund概念治疗方法能降低严重颅脑损伤患者颅脑手术后的病死率.
Objective To explore if the new treatment with Lund concept could reduce the mortality of patients after severe brain injury. Methods This study included 68 severe brain injury patients in whom Gloasgow coma score （GCS） was 3 - 8, and in 30 of them Lund concept was adopted, and the other 38 patients were taken care of by the conventional treatment in controlling intracranial pressure （ICP）.Furthermore, in patients of the Lund group and control group ICP and cerebral perfusion pressure （CPP）were monitored continuously for 5 days. Results The amount of mannitol （g） used was markedly smaller in Lund group than that in the control group （139. 6±25.0 vs. 587.5±31.8, P〈0. 01）. The 28-day mortality of Lund group was significantly lower than that in control group （30. 0% vs. 57.9%, P〈0. 05）. In Lund group, the incidence of ICP exceeding 25 mm Hg （1 mm Hg=0.133 kPa） or 35 mm Hg or lowering of CPP by 50 mm Hg observed in the non-survivors （n = 9） was greater than that observed in the survivors [n = 21,（45.0±23.2）% vs. （7.2±3.6）%, （40.2±18.6）% vs. （2.2±1.6）%, （35.9±12.9）% vs. （3.1±2. 4 ）%, all P〈 0.05]. Conclusion By adopting the Lund concept, it is possible to reduce postoperative mortality after severe head injury.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2010年第10期610-613,共4页
Chinese Critical Care Medicine
基金
基金项目：浙江省医药卫生科技计划项目（20078173）
关键词
Lund概念
颅脑损伤
严重
颅内压
脑灌注压
Lund concept
Severe head injury
Intracranial pressure
Cerebral perfusion pressure
