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自发性脑出血患者的脑灌注压、微透析生物化学和临床转归。

Cerebral perfusion pressure, microdialysis biochemistry, and clinical outcome in patients with spontaneous intracerebral hematomas.

机构信息

Intensive Care Unit, General Hospital of Larissa, Greece.

出版信息

J Crit Care. 2012 Feb;27(1):83-8. doi: 10.1016/j.jcrc.2011.04.004. Epub 2011 Jun 23.

Abstract

PURPOSE

The aim of our study was to investigate the roles of cerebral perfusion pressure (CPP) and microdialysis marker values on the clinical outcome of patients with spontaneous intracerebral hematoma.

MATERIALS AND METHODS

Twenty-seven patients (18 men; mean ± SD age, 54.17 ± 10.05 years; 9 women, mean ± SD age, 65.00 ± 4.24 years) with a GCS of 8 or less upon admission were included in this study. After a 6-month follow-up period, a linear regression model was applied to evaluate the outcomes using the Glasgow Outcome Scale (GOS).

RESULTS

Of the 27 patients, 16 died within the first 6 months after discharge from the hospital. Six patients had a favorable prognosis after 6 months. In the patients who had a favorable outcome (GOS = 4 or GOS = 5), the CPP was above 75.46 mm Hg, and intracranial pressure was below 14.21 mm Hg. No patient with a favorable prognosis had a lactate-pyruvate (L/P) ratio greater than 37.40. An inverse linear relationship was found among the L/P ratio, the CPP, and patient outcome.

CONCLUSION

The L/P ratio and CPP were found to be related to patient outcome. In addition, a CPP greater than 75.46 mm Hg and an L/P ratio lower than 37.40 mm Hg were related to a favorable outcome.

摘要

目的

本研究旨在探讨脑灌注压(CPP)和微透析标志物值在自发性脑出血患者临床转归中的作用。

材料和方法

本研究纳入了 27 例入院时 GCS 评分≤8 的患者(18 例男性,平均年龄±标准差为 54.17±10.05 岁;9 例女性,平均年龄±标准差为 65.00±4.24 岁)。在 6 个月的随访期后,采用线性回归模型根据格拉斯哥结局量表(GOS)评估结局。

结果

在 27 例患者中,16 例在出院后 6 个月内死亡。6 例患者在 6 个月后预后良好。在预后良好的患者(GOS=4 或 GOS=5)中,CPP 高于 75.46mmHg,颅内压低于 14.21mmHg。没有预后良好的患者的乳酸丙酮酸(L/P)比值大于 37.40。L/P 比值、CPP 和患者预后之间存在负相关线性关系。

结论

L/P 比值和 CPP 与患者预后相关。此外,CPP 大于 75.46mmHg 和 L/P 比值小于 37.40mmHg 与良好的预后相关。

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