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重型颅脑损伤患者凝血纤溶标志物动态观察
Objective To investigate the dynamic changes and the clinic significance of coagulation and fibrinolysis markers in patients with severe craniocerebral trauma. Methods Thirty three consecutive patients [Glasgow coma scale (GCS) ≦8 and APACHE II >10] including 10 women and 23 men with age of (46. 3 ± 16. 3) years old and with severe craniocerebral trauma were enrolled in this study. Endothelin(ET),alpha-granular membrane protein-140( GMP-140) and D-dimer(DD) were measured at 1st day ,3rd day and 7th day of admission, head computerized tomography (CT) was performed on each patient.Twenty healthy people with similar age were as control. ET was determined by the reagent kit which from Shanghai Shenjia company and GC-1200 -γ radiatory counter. GMP-140 was determined by the reagent kit which from Suzhou university and PEKINEINMER WIZARD-1470 γ radiatory counter. DD was determined by the reagent kit Shanghai sung biological product company limited and measured by latex agglutination.Results ET,GMP-140 and DD levels were significantly increased at the time of admission [(75. 24 ± 26. 44)pg/ml,(26.43 ± 13. 94) ng/ml, (3. 20 ± 0. 97) μg/ml, respectively ] ,then gradually decreased. ET and DD levels were significantly higher than control group even after 7 days[ (44. 66 ± 15. 25)pg/ml, (1. 35±0.55) μg/ml, respectively ], but not for GMP-140. All of the coagulation and fibrinolysis abnormalities markers were negatively correlated with GCS,P<0. 05. There were 18 survivors including 8 vegetables and 15 dead including 1 case suffered from disseminated intravascular coagulation (DIC) in this investigation.Conclusions Coagulation and fibrinolysis abnormalities markers were occurred at the very early stage in the patients with severe craniocerebral trauma. The levels of ET, GMP-140 and DD levels were negatively correlated with GCS.
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镁离子对颅脑创伤患者的治疗作用
近几年,人们通过动物实验发现,镁离子(Mg2+)作为内源性神经保护因子在颅脑创伤后的脑组织代谢中起着重要作用.大量实验研究证实,Mg2+可预防及减轻颅脑创伤后的继发性脑损伤.
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重型颅脑损伤患者应用亚低温疗法的护理
颅脑损伤为一种常见外伤,由于伤及中枢神经系统,其死亡率高,而亚低温治疗可显著控制脑水肿,降低颅内压,减少脑细胞耗氧,使机体对外界及各种病理性刺激的反应减弱,对机体具有保护作用.
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颅脑创伤术后脑性盐耗综合征的观察及护理
脑性盐耗综合征(cerebral saltwasting syndrome, CSWS)是描述一组由颅内疾病引起的以低钠血症、尿钠增高和低血容量为主要临床表现的综合征[1].
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重症颅脑外伤病人护理中的伦理问题与对策
随着我国社会经济的快速发展,基础建设的极度扩张,家用汽车的普及,因工伤、交通事故导致的颅脑外伤病人呈明显增加趋势.病人入院后家属急躁;肇事人员、单位同事、亲属、邻居来往探视人员较多;病人病情复杂多变,生命体征极不稳定,随时都会有生命危险,有些病人即使已经度过危险期,但因伤情较重仍会处于昏迷状态.因此,护士与病人的交流非常有限甚至不能,而与病人家属沟通较多,围绕病人的伤情、治疗、并发症、护理等,护士与家属的交流常会涉及伦理问题,如何进行有效沟通,规避伦理问题引发的护患矛盾,具有重要意义.
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颅脑损伤患者恢复期的早期康复护理
BACKGROUND:The chief target of rehabilitation care intervention to the craniocerebral trauma patients is to regain the function to the most limits, decrease the sequela and improve the living quality and to turn back and rejoin the society.
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早期康复训练治疗颅脑外伤性运动功能障碍
INTRODUCTION To explore the effects of early rehabilitation training on kinetic dysfunction after craniocerebral trauma,effects of rehabilitation training on patients with hemiplegia are observed in this article.
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181例特重型颅脑创伤术后高压氧治疗及严重并发症的处理
高压氧综合治疗是颅脑创伤术后的主要治疗手段,但由于特重型颅脑创伤多同时伴有颅脑、胸腹部、四肢等多发伤,以及气管切开、肺部感染、胃肠道出血等并发症,治疗极为困难[1-2].
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Numerical Reconstruction and Injury Biomechanism in a Car-Pedestrian Crash Accident