儿童严重外伤性脑损伤的治疗结果。

IF 2.7 4区 医学 Q2 CLINICAL NEUROLOGY
Neurological Sciences Pub Date : 2025-07-01 Epub Date: 2025-04-25 DOI:10.1007/s10072-025-08191-x
Tatyana Sakharova, Dimitar Monov, Nikolay Lilyanov
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引用次数: 0

摘要

本研究的目的是通过评估脑损伤的相关因素来提高诊断为严重颅脑损伤的儿童的治疗效果。该研究的重点是评估输液治疗对SCCT患儿病情改善的影响,特别是通过评估水平衡指标。通过改变激素浓度(促甲状腺素(TSH)、皮质醇(C)、催乳素(P))来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浓度。共纳入804例孤立性严重颅脑损伤(SCCT)患儿,并分为回顾性(n = 474)和前瞻性(n = 100)两组。水平衡阴性患儿的死亡率高于水平衡阳性患儿(24% vs. 10%, p≤0.05)。积极的水平衡,结合适当的输注治疗和补液,积极影响严重颅脑外伤(SCCT)的预后。这些发现可以应用于临床实践,以优化儿童SCCT的治疗,改善其预后。48 h后,清醒患儿总蛋白水平(59.9±1.5 g/L, p≤0.05)高于死亡患儿(54.9±1.6 g/L, p≤0.05)。应激性高血糖与严重颅脑损伤的严重程度相关。本研究证实了输液治疗在儿童SCCT治疗中的意义。总蛋白、葡萄糖和P浓度的指标可以作为评估SCCT严重程度和预后的有价值的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Results of therapy in children diagnosed with severe traumatic brain injury.

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.

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来源期刊
Neurological Sciences
Neurological Sciences 医学-临床神经学
CiteScore
6.10
自引率
3.00%
发文量
743
审稿时长
4 months
期刊介绍: Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.
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