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）;L...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.展开更多
Objectives:Chronic rhinosinusitis is one of the common diseases that cause morbidity and affects a person's quality of life.We tried to provide a more appropriate and effective approach to selecting patients for e...Objectives:Chronic rhinosinusitis is one of the common diseases that cause morbidity and affects a person's quality of life.We tried to provide a more appropriate and effective approach to selecting patients for endoscopic sinus surgery.Methods:The study population is chronic rhinosinusitis children referred to the ear,nose,and throat clinic of two general hospitals in Tehran,Iran,who have previously undergone sufficient drug treatment and have not recovered.The Lund–Mackay score is calculated by examining the computed tomography(CT)scan.The Sino-nasal Outcome Test-22(SNOT-22)questionnaire was provided to the patients before the operation,after the operation,and 3 and 6 months later in the clinic.Results:Before the operation,the most SNOT-22 score people were in the range of 40–59 points.The SNOT-22 score before the operation is significantly different from 3 and 6 months after the operation.The highest frequency of Lund–Mackay CT(LMCT)scan score was in the range of 18–23 points.The LMCT scan score did not show any significant relationship with the SNOT-22 score before surgery,3 months,and 6 months after surgery.Sensitivity to aspirin had a significant relationship with SNOT-22 scores and the history of asthma and nasal polyps had a significant relationship with the preoperative LMCT scan score.Conclusions:The LMCT scan scoring system cannot be a good measure of chronic rhinosinusitis severity or the prognosis of patients after surgery.The SNOT-22 questionnaire can be used as a predictive tool to help the doctor and the patient in deciding to operate and the possibility of obtaining a relative recovery.展开更多
文摘目的 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.
文摘Objectives:Chronic rhinosinusitis is one of the common diseases that cause morbidity and affects a person's quality of life.We tried to provide a more appropriate and effective approach to selecting patients for endoscopic sinus surgery.Methods:The study population is chronic rhinosinusitis children referred to the ear,nose,and throat clinic of two general hospitals in Tehran,Iran,who have previously undergone sufficient drug treatment and have not recovered.The Lund–Mackay score is calculated by examining the computed tomography(CT)scan.The Sino-nasal Outcome Test-22(SNOT-22)questionnaire was provided to the patients before the operation,after the operation,and 3 and 6 months later in the clinic.Results:Before the operation,the most SNOT-22 score people were in the range of 40–59 points.The SNOT-22 score before the operation is significantly different from 3 and 6 months after the operation.The highest frequency of Lund–Mackay CT(LMCT)scan score was in the range of 18–23 points.The LMCT scan score did not show any significant relationship with the SNOT-22 score before surgery,3 months,and 6 months after surgery.Sensitivity to aspirin had a significant relationship with SNOT-22 scores and the history of asthma and nasal polyps had a significant relationship with the preoperative LMCT scan score.Conclusions:The LMCT scan scoring system cannot be a good measure of chronic rhinosinusitis severity or the prognosis of patients after surgery.The SNOT-22 questionnaire can be used as a predictive tool to help the doctor and the patient in deciding to operate and the possibility of obtaining a relative recovery.
