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目的探讨弥漫性弥漫性轴索损伤重症监护的策略及其与患者预后及并发症的相关性。方法回顾性分析近5年来,某科收治的弥漫性轴索损伤的患者共计103例,对其重症监护情况进行总结分析,并将颅内压监护组与未进行颅内压监护组、常规气管切开组与出现低氧血症时气管切开组的患者的预后和并发症情况进行统计学分析,以讨论重症监护策略与患者雨预后的相关性。结果颅内压监护组患者消化道出血和肾功能衰竭的发生率明显低于未进行颅内压监护组,死亡率也明显低于后者,差异有统计学意义(P﹤0.05),常规气管切开组与低氧血症时气管切开组之间发生并发症的情况无明显差异,而常规气管切开组的预后良好率明显优于对照组,差异有统计学意义(P﹤0.05)。结论 DAI患者重症监护策略,除了常规的监护措施外,应该尽早进行气管切开、加强颅内压监护,以减少并发症,提高患者预后情况。
Objective To investigate the strategy of intensive monitoring of diffuse axonal injury and its relationship with prognosis and complications. Methods A retrospective analysis of the past 5 years, a section of diffuse axonal injury admitted to a total of 103 cases of patients with intensive care status were analyzed, and the intracranial pressure monitoring group and without intracranial pressure monitoring group, conventional trachea The prognosis and complications of patients in the incision group and the tracheotomy group in the presence of hypoxemia were statistically analyzed to discuss the relevance of the intensive care strategy to the patient’s prognosis of the disease. Results The incidence of gastrointestinal bleeding and renal failure was significantly lower in the ICU monitoring group than in the non-ICU monitoring group and the mortality was significantly lower than the latter (P <0.05). The conventional trachea There was no significant difference in the complications between the incision group and the tracheotomy group when compared with the hypoxemia group. The good prognosis of the conventional tracheotomy group was significantly better than that of the control group (P <0.05) . Conclusion In intensive care strategy of DAI patients, tracheotomy should be carried out as soon as possible in addition to routine custody measures to strengthen the monitoring of intracranial pressure in order to reduce the complications and improve the prognosis of patients.