重型颅脑损伤患者血清淀粉酶水平对患者预后的评估价值
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摘要
目的分析重型颅脑损伤患者血清淀粉酶(AMY)水平对临床预后的评估价值。方法选择2014年6月～2017年6月期间收治的106例重型颅脑损伤患者为研究对象,根据格拉斯哥昏迷评分(GCS)高低分为特重型亚组(GCS评分为3～5分)50例、重型亚组(GCS评分为6～8分)56例。所有患者均在就诊24 h内检测其AMY,治疗15 d后评估其临床预后情况。另外选择同期收治的50例轻型颅脑损伤患者作为对照组,同样在24 h内检测AMY,对比分析几组患者的临床预后差异。结果重型组预后良好率为57.55%,明显低于对照组(90.00%),差异有统计学意义(χ~2=16.429 7,P <0.05);重型组患者AMY值(295.5±12.5)U/L、AMY异常率为32.08%,明显高于对照组(P <0.05);AMY异常组GCS 3～5分比例73.53%,植物生存比例73.53%,明显高于AMY正常组(P <0.05)。结论重型颅脑损伤患者AMY水平明显高于正常,且AMY水平越高者预后越差, AMY可作为预后评估的指标。
Objective To evaluate the value of serum amylase level in patients with severe craniocerebral injury. Methods 106 patients with severe craniocerebral injury(TBI) treated in our hospital from June 2014 to June 2017 were selected as the study subjects. According to the GCS score(Glasgow coma score), 50 cases were divided into the extra severe subgroup(GCS score 3 ～ 5). Severe subgroup(GCS score 6 ～ 8) 56 cases. AMY(serum amylase) was detected in all patients within 24 hours and the clinical prognosis was evaluated 15 days after treatment. In addition, 50 mild TBI patients in the same period were selected as control group, and their clinical prognosis was compared and analyzed in 24 hours. Results The rate of good prognosis in severe group was 57.55% significantly lower than that in control group(90.00%, P < 0.05), and the AMY value of severe group(295.5 ±12.5) was significantly higher than that of control group(32.08%), and the difference between the two groups was statistically significant(P < 0.05). Ratio of GCS 3 to 5 in abnormal AMY group 7 3.53% and 73.53% of plant survival rate were significantly higher than that of normal AMY group(P < 0. 05). Conclusion The level of AMY in patients with severe TBI is significantly higher than that in normal patients, and the higher the level of AMY is, the worse the prognosis is. AMY can be used as one of the important prognostic indicators in clinical diagnosis and treatment.
Objective To evaluate the value of serum amylase level in patients with severe craniocerebral injury. Methods 106 patients with severe craniocerebral injury(TBI) treated in our hospital from June 2014 to June 2017 were selected as the study subjects. According to the GCS score(Glasgow coma score), 50 cases were divided into the extra severe subgroup(GCS score 3 ～ 5). Severe subgroup(GCS score 6 ～ 8) 56 cases. AMY(serum amylase) was detected in all patients within 24 hours and the clinical prognosis was evaluated 15 days after treatment. In addition, 50 mild TBI patients in the same period were selected as control group, and their clinical prognosis was compared and analyzed in 24 hours. Results The rate of good prognosis in severe group was 57.55% significantly lower than that in control group(90.00%, P < 0.05), and the AMY value of severe group(295.5 ±12.5) was significantly higher than that of control group(32.08%), and the difference between the two groups was statistically significant(P < 0.05). Ratio of GCS 3 to 5 in abnormal AMY group 7 3.53% and 73.53% of plant survival rate were significantly higher than that of normal AMY group(P < 0. 05). Conclusion The level of AMY in patients with severe TBI is significantly higher than that in normal patients, and the higher the level of AMY is, the worse the prognosis is. AMY can be used as one of the important prognostic indicators in clinical diagnosis and treatment.
引文
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[10]秦学军.血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义.中国实用医药,2013,8(7):44-45.
[11]余大超.颅脑损伤GCS评分与CT像计分与临床预后的相关性研究.牡丹江医学院学报,2015,36(5):16-17.
[12]马鸿凯.重型颅脑外伤并大面积脑梗死神经外科治疗临床体会.中国医学工程,2014,10(12):69-72.
[2]邬闻文,金奕,徐旭东,等.颅脑损伤伴肢体运动障碍患者创伤后成长促进因素的质性研究.中国实用护理杂志,2013,29(33):44-46.
[3]邵敏.优质护理在颅脑外伤患者中的应用效果观察.中国医药指南,2015,13(12):245-246.
[4]梁建锋,朱振云,张红彬,等.对神经外科危重颅脑外伤患者治疗方案的分析.当代医药论丛,2014,12(7):210.
[5]邓燕婷,刘燕兰,杨露宁.优质护理在颅脑外伤患者中应用的效果分析.中国医药指南,2015,13(21):19-21.
[6]王冬梅,常杰,白云贤,等.急性颅脑损伤血清性激素水平变化与预后的研究.中华神经外科杂志,2014,30(7):715-717.
[7]潘彦波.神经外科危重颅脑外伤的临床治疗分析体会.中国伤残医学,2016,24(3):63-64
[8]鲁琳,聂智容.颅脑损伤在手术室中的护理救治流程.护士进修杂志,2014,29(5):435-438.
[9]江川.钠代谢紊乱对重型颅脑损伤患者病情及预后评价临床应用研究.河北医学,2016,22(1):102-105.
[10]秦学军.血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义.中国实用医药,2013,8(7):44-45.
[11]余大超.颅脑损伤GCS评分与CT像计分与临床预后的相关性研究.牡丹江医学院学报,2015,36(5):16-17.
[12]马鸿凯.重型颅脑外伤并大面积脑梗死神经外科治疗临床体会.中国医学工程,2014,10(12):69-72.