Sazbon L, Fuchs C, Costeff H
Loewenstein Hospital, Rehabilitation Center, Ra'anana, Israel.
J Neurol Neurosurg Psychiatry. 1991 Feb;54(2):149-52. doi: 10.1136/jnnp.54.2.149.
This study reviews the course and outcome of 130 patients who remained in a state of prolonged unawareness 30 days after severe cranio-cerebral trauma. Prognostic indicators and outcome were fitted by a logistic model. The significant prognostic factors observable in the first week after trauma were found to be ventilatory status, motor reactivity and significant extraneural trauma. The significant prognostic factors after the first month of unawareness were early ventilatory status, early motor reactivity, late epilepsy and hydrocephalus. The estimated probability of recovery of awareness (that is, consciousness) ranged from 0.94 in patients with early decorticate posturing in the absence of both extraneural trauma and ventilatory disturbance to 0.06 in patients with flaccidity, extraneural trauma and ventilatory disturbance in the first week after injury.
本研究回顾了130例重度颅脑创伤30天后仍处于长期无意识状态患者的病程及预后。通过逻辑模型拟合预后指标和结果。发现创伤后第一周可观察到的显著预后因素为通气状态、运动反应性和严重的神经外创伤。无意识状态第一个月后的显著预后因素为早期通气状态、早期运动反应性、晚期癫痫和脑积水。意识恢复(即苏醒)的估计概率范围为:在伤后第一周无神经外创伤和通气障碍且早期出现去皮质强直姿势的患者中为0.94,在伤后第一周出现弛缓性麻痹、神经外创伤和通气障碍的患者中为0.06。