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Updated: Oct 8, 2026

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血压变化和创伤性脑损伤患者的预测结果患有扩散轴突损伤的患者:回顾性队列研究

Christine E Ren^1,2, Anastasia Ternovskaia³, Fatima Mikdashi³

¹R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Department of Emergency Medicine-Surgical Critical Care, Baltimore, Maryland.

The western journal of emergency medicine

|March 27, 2025

概括

血压的变化没有影响扩散轴突损伤患者的结果. 下格拉斯哥昏迷量表得分,更高的INR和脑预测严重创伤性脑损伤的结果更差.

科学领域:

神经科学是一个神经科学.
创伤外科手术创伤外科
关键护理医学关键护理医学

背景情况:

扩散轴突损伤 (DAI) 是创伤性脑损伤 (TBI) 的严重后果,具有显著的发病率和死亡率.
血压变化 (BPV) 在TBI结果中的作用已经确立,但其对DAI患者的具体影响仍然不清楚.

研究的目的:

调查24小时创伤后血压变化与DAI患者结局之间的关联.
确定其他影响DAI患者结果的临床因素.

主要方法:

在一级创伤中心对被诊断为DAI的TBI患者的回顾性分析.
评估的结果包括医院处置和在医院5日的格拉斯哥昏迷表 (GCS) (HD5GCS).
顺序逻辑回归被用来分析与临床因素的关联.

主要成果:

通过静脉血压变化 (SBP_SV) 和标准偏差 (SBP_SD) 测量的BPV,与住院处置或HD5GCS没有显著关联.
较高的初始国际正常化比率 (INR),脑损伤的存在和较低的HD5GCS与增加死亡或临终关怀出院的几率有关.
血液制品,血管压缩剂,高度治疗和同时发生的腹腔内出血与较差的HD5GCS相关.

结论:

血压变化与被诊断患有扩散轴突损伤的患者的结果无关.
在医院5日降低GCS,提高初始INR,并发脑是DAI中不良结果的显著预测因素.

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