I. Koshman, A. Kalinichev, A. Shchegolev, I. E. Shaludkin
{"title":"应用全身血管保护器矫正术后早期颅内血肿患者的外伤性颅内高血压","authors":"I. Koshman, A. Kalinichev, A. Shchegolev, I. E. Shaludkin","doi":"10.24884/2072-6716-2021-22-4-60-69","DOIUrl":null,"url":null,"abstract":"Post-traumatic brain edema is integral pathophysiological process in patients with severe traumatic brain injury, leading to increase of intracranial pressure (ICP). Intracranial hypertension (ICH), in turn, increases the number of deaths in this group of patients. The most important task in the treatment of victims in the early postoperative period after the removal of traumatic intracranial hematomas is correction of ICH syndrome.Purpose of the study. To evaluate the effect of the systemic angioprotector use on the treatment outcomes of patients with traumatic intracranial hematomas in the early postoperative period.Materials and methods. The study included 50 patients with traumatic intracranial hematomas. Group I — the main group (with the use of systemic angioprotector, n=24), group II — the comparison group (without the use of the medication, n=26). The effectiveness of treatment was compared — according to the following criteria: survival in the postoperative period (14 days), level of consciousness (at admission and average value during the day throughout the treatment), course of neurological status: meningeal signs, cranial nerve function, motor sphere, response to pain stimuli, autonomic system disorders (at admission and every day throughout the treatment), monitoring of ICP (before removal of the hematoma and average value throughout the measurement), changes in the multispiral computed tomogram of the head (at admission, on the 3rd, 7th, 14th day).Results. The study found that the mortality rate in the main group of patients with intracranial hematomas in the early postoperative period decreased by 21.5%. The average value of ICP for the entire period of measurement in group I is 15.0±7.6, in group II 17.3±8.4 mm Hg. The average value of points of the Glasgow com scale on the 14th day in group I is 9.2±1.9, in group II 7.5±0.7 points. The duration of intraventricular monitoring of ICP was less in the first group — 4.3±1.2 days, compared to the second group — 6.2±1.5 days.Conclusion. The use of systemic angioprotector in the complex treatment can reduce intracranial pressure (ICP) in patients with traumatic intracranial hematomas in the early postoperative period and improve intermediate outcomes.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Traumatic intracranial hipertension correction in patients with intracranial hematomas during the early postoperative period with the use of systemic angioprotector\",\"authors\":\"I. Koshman, A. Kalinichev, A. Shchegolev, I. E. Shaludkin\",\"doi\":\"10.24884/2072-6716-2021-22-4-60-69\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Post-traumatic brain edema is integral pathophysiological process in patients with severe traumatic brain injury, leading to increase of intracranial pressure (ICP). Intracranial hypertension (ICH), in turn, increases the number of deaths in this group of patients. The most important task in the treatment of victims in the early postoperative period after the removal of traumatic intracranial hematomas is correction of ICH syndrome.Purpose of the study. To evaluate the effect of the systemic angioprotector use on the treatment outcomes of patients with traumatic intracranial hematomas in the early postoperative period.Materials and methods. The study included 50 patients with traumatic intracranial hematomas. Group I — the main group (with the use of systemic angioprotector, n=24), group II — the comparison group (without the use of the medication, n=26). The effectiveness of treatment was compared — according to the following criteria: survival in the postoperative period (14 days), level of consciousness (at admission and average value during the day throughout the treatment), course of neurological status: meningeal signs, cranial nerve function, motor sphere, response to pain stimuli, autonomic system disorders (at admission and every day throughout the treatment), monitoring of ICP (before removal of the hematoma and average value throughout the measurement), changes in the multispiral computed tomogram of the head (at admission, on the 3rd, 7th, 14th day).Results. The study found that the mortality rate in the main group of patients with intracranial hematomas in the early postoperative period decreased by 21.5%. The average value of ICP for the entire period of measurement in group I is 15.0±7.6, in group II 17.3±8.4 mm Hg. The average value of points of the Glasgow com scale on the 14th day in group I is 9.2±1.9, in group II 7.5±0.7 points. The duration of intraventricular monitoring of ICP was less in the first group — 4.3±1.2 days, compared to the second group — 6.2±1.5 days.Conclusion. The use of systemic angioprotector in the complex treatment can reduce intracranial pressure (ICP) in patients with traumatic intracranial hematomas in the early postoperative period and improve intermediate outcomes.\",\"PeriodicalId\":37398,\"journal\":{\"name\":\"Sklifosovsky Journal Emergency Medical Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sklifosovsky Journal Emergency Medical Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.24884/2072-6716-2021-22-4-60-69\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sklifosovsky Journal Emergency Medical Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24884/2072-6716-2021-22-4-60-69","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
创伤后脑水肿是重型颅脑损伤患者不可缺少的病理生理过程,可导致颅内压升高。颅内高压反过来又增加了这类患者的死亡人数。外伤性颅内血肿切除后患者术后早期治疗的首要任务是颅内出血综合征的矫正。研究目的:目的探讨全身血管保护剂对创伤性颅内血肿术后早期治疗效果的影响。材料和方法。本研究包括50例外伤性颅内血肿患者。I组为主要组(使用全身血管保护剂,n=24), II组为对照组(未使用药物,n=26)。根据以下标准对治疗效果进行比较:术后生存期(14天)、意识水平(入院时和整个治疗过程中白天的平均值)、神经系统状态病程:脑膜征象、脑神经功能、运动球、对疼痛刺激的反应、自主神经系统紊乱(入院时及整个治疗过程中每天)、ICP监测(血肿去除前及整个测量过程中的平均值)、头部多螺旋ct变化(入院时、第3、7、14天)。研究发现,颅内血肿主组患者术后早期死亡率下降21.5%。I组全测量期ICP平均值为15.0±7.6 mm Hg, II组为17.3±8.4 mm Hg,第14天格拉斯哥评分平均值为9.2±1.9分,II组为7.5±0.7分。第一组颅内压监测时间(4.3±1.2 d)短于第二组(6.2±1.5 d)。综合治疗中应用全身血管保护剂可降低创伤性颅内血肿术后早期颅内压(ICP),改善中期预后。
Traumatic intracranial hipertension correction in patients with intracranial hematomas during the early postoperative period with the use of systemic angioprotector
Post-traumatic brain edema is integral pathophysiological process in patients with severe traumatic brain injury, leading to increase of intracranial pressure (ICP). Intracranial hypertension (ICH), in turn, increases the number of deaths in this group of patients. The most important task in the treatment of victims in the early postoperative period after the removal of traumatic intracranial hematomas is correction of ICH syndrome.Purpose of the study. To evaluate the effect of the systemic angioprotector use on the treatment outcomes of patients with traumatic intracranial hematomas in the early postoperative period.Materials and methods. The study included 50 patients with traumatic intracranial hematomas. Group I — the main group (with the use of systemic angioprotector, n=24), group II — the comparison group (without the use of the medication, n=26). The effectiveness of treatment was compared — according to the following criteria: survival in the postoperative period (14 days), level of consciousness (at admission and average value during the day throughout the treatment), course of neurological status: meningeal signs, cranial nerve function, motor sphere, response to pain stimuli, autonomic system disorders (at admission and every day throughout the treatment), monitoring of ICP (before removal of the hematoma and average value throughout the measurement), changes in the multispiral computed tomogram of the head (at admission, on the 3rd, 7th, 14th day).Results. The study found that the mortality rate in the main group of patients with intracranial hematomas in the early postoperative period decreased by 21.5%. The average value of ICP for the entire period of measurement in group I is 15.0±7.6, in group II 17.3±8.4 mm Hg. The average value of points of the Glasgow com scale on the 14th day in group I is 9.2±1.9, in group II 7.5±0.7 points. The duration of intraventricular monitoring of ICP was less in the first group — 4.3±1.2 days, compared to the second group — 6.2±1.5 days.Conclusion. The use of systemic angioprotector in the complex treatment can reduce intracranial pressure (ICP) in patients with traumatic intracranial hematomas in the early postoperative period and improve intermediate outcomes.
期刊介绍:
The Journal "Neotlozhnaia meditsinskaia pomoshch" (parallel titles: Zhurnal im. N.V. Sklifosovskogo "Neotlozhnai︠a︡ medit︠s︡inskai︠a︡ pomoshch", "Sklifosovsky Journal of Emergency Medical Care") seeks to publish original research articles, literature reviews, case reports, brief reports on clinical practice, and other suitable material submitted by professionals involved in the diagnosis and treatment of acute medical and surgical conditions.