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[格拉斯哥昏迷量表在小儿颅脑创伤中的应用]

[Use of the Glasgow Coma Scale in pediatric craniocerebral trauma].

作者信息

Stenger R D, Schmidt S, Beyer B, Sehl U

机构信息

Klinik und Poliklinik für Kindermedizin, Ernst-Moritz-Arndt-Universität Greifswald.

出版信息

Kinderarztl Prax. 1993 Dec;61(10):359-64.

PMID:8145452
Abstract

Over five years the applicability of a modified Glasgow Coma Scale was analysed in 38 children (mean age 7.2 +/- 3.8 years) with head and associated injuries (47.4%). The score was estimated after the accident and in the course of intensive therapy. At the beginning of the treatment on the intensive care unit, the cases were staged according to the severity of the head injuries (Glasgow Coma Scale: 4-8, 9-12 and 13-19 points). At the stage evaluated as between 4 and 8 points, 50% of the patients died and the survivors were ventilated (11.7 +/- 10.7 days) and intensively treated (45.7 +/- 31.5 days). All patients had had neurological damage. Additional injuries worsened the prognosis in the acute phase. 42.9% of the patients received intracranial pressure monitoring. In the patients between 9 and 12 points, the time of ventilation (3.7 +/- 2.9 days) and of intensive therapy (19.5 +/- 13.3 days) decreased. Over 13 points, all patients had a shorter duration of treatment (10.8 +/- 8.8 days) and a quick and good recovery. The Glasgow Coma Scale has the advantage of an examination with a quantitative analysis and resulting effective diagnostic and therapeutic measures. Even the inexperienced physician can use the Glasgow Coma Scale with success at the site of the accident.

摘要

在五年时间里,对38名头部及相关部位受伤的儿童(平均年龄7.2±3.8岁)(占47.4%)分析了改良格拉斯哥昏迷量表的适用性。在事故发生后及强化治疗过程中对该评分进行评估。在重症监护病房开始治疗时,根据头部损伤的严重程度(格拉斯哥昏迷量表:4 - 8分、9 - 12分和13 - 19分)对病例进行分级。在评估为4至8分的阶段,50%的患者死亡,幸存者接受通气治疗(11.7±10.7天)和强化治疗(45.7±31.5天)。所有患者均有神经损伤。其他损伤在急性期使预后恶化。42.9%的患者接受了颅内压监测。在9至12分的患者中,通气时间(3.7±2.9天)和强化治疗时间(19.5±13.3天)缩短。超过13分,所有患者的治疗时间较短(10.8±8.8天)且恢复迅速良好。格拉斯哥昏迷量表具有通过定量分析进行检查并由此产生有效诊断和治疗措施的优势。即使是经验不足的医生也能在事故现场成功使用格拉斯哥昏迷量表。

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