Sakharova Tatyana, Monov Dimitar, Lilyanov Nikolay
Department of Biology and General Genetic, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Department of Anaesthesiology and Intensive Care, Medical University Sofia, 1000. Zdrave 2A str, Sofia, 1407, Bulgaria.
Neurol Sci. 2025 Apr 25. doi: 10.1007/s10072-025-08191-x.
The aim of this research is to enhance therapeutic outcomes in children diagnosed with severe craniocerebral trauma by evaluating the contributing factors involved in cerebral injury. The investigation focused on evaluating the impact of infusion therapy on the improvement of pediatric patients' conditions with SCCT, particularly by assessing hydrobalance indicators. Adaptive changes associated with the humoral stress response were evaluated through alterations in hormone concentrations (thyrotropin (TSH), cortisol (C), prolactin (P)). Concentrations of plasma protein and glucose were analyzed. A total of 804 children with isolated severe craniocerebral trauma (SCCT) were enrolled and stratified into retrospective (n = 474) and prospective (n = 100) cohorts. Children with negative hydrobalance exhibited a higher mortality rate compared to those with positive hydrobalance (24% vs. 10%, p ≤ 0.05). Positive hydrobalance, in conjunction with appropriate infusion therapy and rehydration, positively influenced the prognosis of severe cranio-cerebral trauma (SCCT). These findings can be applied in clinical practice to optimize the treatment of children with SCCT and improve their prognosis. The level of total protein was higher in conscious children after 48 h (59.9 ± 1.5 g/L, p ≤ 0.05) in comparison to deceased individuals (54.9 ± 1.6 g/L, p ≤ 0.05). Stress-induced hyperglycemia was associated with the severity of severe cranio-cerebral trauma. The study corroborated the significance of infusion therapy in the treatment of children with SCCT. Indicators of total protein, glucose, and P concentrations can serve as valuable tools for assessing the severity and prognostication of SCCT.
本研究的目的是通过评估脑损伤的相关因素，提高被诊断为重度颅脑创伤儿童的治疗效果。该调查聚焦于评估输液治疗对重度颅脑创伤（SCCT）儿科患者病情改善的影响，特别是通过评估水平衡指标。通过激素浓度（促甲状腺激素（TSH）、皮质醇（C）、催乳素（P））的变化评估与体液应激反应相关的适应性变化。分析血浆蛋白和葡萄糖的浓度。共纳入804例孤立性重度颅脑创伤（SCCT）儿童，并分为回顾性队列（n = 474）和前瞻性队列（n = 100）。水平衡为负的儿童死亡率高于水平衡为正的儿童（24% 对10%，p≤0.05）。正水平衡与适当的输液治疗和补液相结合，对重度颅脑创伤（SCCT）的预后产生积极影响。这些发现可应用于临床实践，以优化SCCT儿童的治疗并改善其预后。与死亡个体（54.9±1.6 g/L，p≤0.05）相比，意识清醒儿童在48小时后的总蛋白水平更高（59.9±1.5 g/L，p≤0.05）。应激性高血糖与重度颅脑创伤的严重程度相关。该研究证实了输液治疗在SCCT儿童治疗中的重要性。总蛋白、葡萄糖和P浓度指标可作为评估SCCT严重程度和预后的有价值工具。
