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重度创伤性脑损伤患者格拉斯哥评分与生存期的相关性

Correlations Between the Glasgow Score and the Survival Period in Patients with Severe Traumatic Brain Injury.

作者信息

Ţolescu RĂzvan Ştefan, ZorilĂ Marian Valentin, ZĂvoi Roxana Eugenia, Popescu Cristina, Dumitru Ilie, Oprica Alexandru Constantin, MogoantĂ LaurenŢiu

机构信息

PhD Student, Department of Histology, University of Medicine and Pharmacy of Craiova, Romania.

Department of Forensic Medicine, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2020 Oct-Dec;46(4):412-419. doi: 10.12865/CHSJ.46.04.13. Epub 2020 Dec 31.

Abstract

Traumatic brain injury (TBI) contributes by 30% to the mortality induced by traumatic injuries, also being one of the major causes of invalidity worldwide. The clinical classification of the severity of mild, moderate or severe TBI is made according to the Glasgow scale, according to the patient's conscious state, motric changes, speech changes and eye opening. In our study, we evaluated the correlation between the Glasgow score at admission and the survival period of patients suffering from TBI, using the data recorded in the Forensic Medicine Institute of Craiova between 2011-2017 on 1005 cases with the diagnosis of death by TBI. We observed that TBI affects persons of all ages, starting from babies up to the elderly aged over 90 years old. Regarding the generation mechanism, most deaths were caused by fallings (438 cases, 43.58%), followed by car accidents (333 cases, representing 33.13%). The number of patients who presented a post-traumatic survival period was 802 (79.80%), of which 779 adults (77.51%) and 23 children (2.29%). Among these, 785 (78.11%-764 adults and 21 children) were hospitalized, while in 64.58% of the TBI patients there was recorded the Glasgow score at admission. 75% of the TBI patients in whom there was recorded the Glasgow score presented a 1st-4th coma degree, with a Glasgow score from 3 to 8 and only 25% had a slightly altered or preserved conscious state, with a Glasgow score=9-15. The survival period varied from less than 24 hours to over 15 days. In the hospitalized patients, there were performed emergency surgeries in 269 (26.76%) cases, the surgical intervention being temporized in 108 (10.74%) patients.

摘要

创伤性脑损伤(TBI)导致的死亡率占创伤性损伤所致死亡率的30%,也是全球致残的主要原因之一。轻度、中度或重度TBI严重程度的临床分类是根据格拉斯哥量表,依据患者的意识状态、运动变化、言语变化和睁眼情况来进行的。在我们的研究中,我们利用克拉约瓦法医学研究所2011年至2017年记录的1005例TBI诊断死亡病例的数据,评估了入院时格拉斯哥评分与TBI患者生存期之间的相关性。我们观察到TBI影响所有年龄段的人,从婴儿到90岁以上的老年人。关于发病机制,大多数死亡是由跌倒(438例,43.58%)引起的,其次是车祸(333例,占33.13%)。有创伤后生存期的患者有802例(79.80%),其中779例为成年人(77.51%),23例为儿童(2.29%)。其中,785例(78.11%——764例成年人和21例儿童)住院治疗,而64.58%的TBI患者记录了入院时的格拉斯哥评分。记录了格拉斯哥评分的TBI患者中,75%呈现1至4级昏迷程度,格拉斯哥评分为3至8分,只有25%的患者意识状态略有改变或保持正常,格拉斯哥评分为9至15分。生存期从不到24小时到超过15天不等。在住院患者中,269例(26.76%)进行了急诊手术,108例(10.74%)患者的手术干预被推迟。

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