杨子才 周忠义 李平雨

[摘要]目的 总结分析早期腰大池持续引流联合硫酸镁对弥漫性轴索损伤治疗的临床效果以及治疗安全性。方法 选取2014年8月～2017年8月我院收治的80例弥漫性轴索损伤患者作为研究对象，按照随机数字表法分为观察组与对照组，每组各40例。对照组早期给予腰大池持续引流，观察组早期给予腰大池持续引流+硫酸镁，比较两组患者的临床疗效及安全性。结果 观察组患者治疗后的日常生活能力评分（ADL）、格拉斯哥昏迷指数（GCS）评分、简易精神状态量表（MMSE）评分均高于对照组，差异有统计学意义（P<0.05）；观察组患者预后的植物生存率低于对照组，差异有统计学意义（P<0.05）；两组患者的并发症总发生率比较，差异无统计学意义（P>0.05）。结论 早期腰大池持续引流联合硫酸镁治疗弥漫性轴索损伤，有利于改善患者预后，提高患者生活和精神状态，同时用药安全性高，值得推广应用。

[关键词]早期腰大池持续引流；硫酸镁；弥漫性轴索损伤；临床疗效；安全性

[中图分类号] R651.15 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0091-03

[Abstract] Objective To summarize and analyze the clinical efficacy and treatment safety of early continuous lumbar cistern drainage in combination with magnesium sulfate for diffuse axonal injury （DAI）. Methods Eighty DAI patients admitted to our hospital from August 2014 to August 2017 were selected as study objects. According to the random number table method， they were divided into observation group and control group， with 40 cases in each group. In the control group， early continuous lumbar cistern drainage alone was used， while in the observation group， early continuous lumbar cistern drainage plus magnesium sulfate was adopted. The clinical efficacy and safety of the two groups were compared. Results After treatment， the activity of daily living （ADL） score， Glasgow Coma Scale （GCS） score and Mini-Mental State Examination （MMSE） score in the observation group were all higher than those in the control group， with statistical significances （P<0.05）. In the observation group， the survival rate of vegetative was lower than that in the control group， with a significant difference （P<0.05）. There was no significant difference in incidence of complications between the two groups （P>0.05）. Conclusion The combination of early continuous lumbar cistern drainage and magnesium sulfate for DAI is beneficial to patient′s prognosis improvement as well as the life and mental state amelioration. At the same time， the drug safety is high， and it is worthy of promotion and application.

[Key words] Early continuous lumbar cistern drainage； Magnesium sulfate； Diffuse axonal injury； Clinical efficacy； Safety

彌漫性轴索损伤属于一种颅脑外伤，在闭合性颅脑外伤中较为常见。近年来，弥漫性轴索损伤的发病率呈现上升趋势，且该病具有脑内神经轴索断裂这一典型特征。在明确诊断基础上需及时进行治疗，早期腰大池持续引流属于弥漫性轴索损伤治疗的常用方法[1]。随着研究的深入，有学者认为镁离子在脑组织循环中具有重要作用[2]。本研究选取80例弥漫性轴索损伤患者作为研究对象，旨在探讨早期腰大池持续引流联合硫酸镁对其治疗效果以及安全性，现报道如下。

1资料及方法

1.1一般资料