ABSTRACT
Objective To explore the clinical value of early application of nimodipine combined with lumbar cistern drainage in the treatment of severe traumatic brain injury .Methods a total of 68 cases elderly patients with severe craniocerebral injury in our hospital from 2015 to 2017 were selected ,which were divided into control group and observation group according to random number table method .The control group was given routine medical treatment ,and the observation group was given nimodipine combined with lumbar cistern drainage on the basis of the control group .The Glasgow Coma Scale (GCS) score ,cerebral CT and blood flow velocity measurement of middle cerebral artery (MCA) were was performed ,and the recovery and prognosis were compared in the two groups .Results The GOS score and MCA blood flow velocity of the observation group at 7 ,14 and 21d after treatment were significantly higher than those in the control group(P＜0 .05);the decline rate of intracranial pressure in the observation group at 7 ,10 and 14d after treatment was significantly higher than that in the control group (P＜0 .05);the probability of infection in the observation group was significantly lower than that in the control group (P＜0 .05);the prognosis rate of the observation group was significantly better than that of the control group(P＜0 .01) .Conclusion Early use of nimodipine combined with lumbar continuous drainage in the treatment of severe traumatic brain injury can effectively improve the clearance rate of subarachnoid hemorrhage ,re-duce the occurrence of secondary brain injury ,avoid cerebral vasospasm ,and improve the prognosis of patients.
ABSTRACT
Objective To analyze the inducement,clinical manifestations,diagnosis and treatment of diabetes patients with multiple organ failure(MOF).Methods A retrospective analysis of 64 diabetes patients with multiple organ failure was executed,the clinical data were statistically analyzed.Results Heart failure was the most common in 64 cases with a incidence of 100.0％,the rest common failure organ were kidney(92.2％ ),brain( 32.8％ ),lung ( 14.1％ ),gastrointestinal tract (3.1％ ),and liver( 1.6％ ).Cases with the glucose level over 33.5mmol/L illustrated a significantly higher incidence than other groups ( P ＜ 0.05 ),glucose level between 22.5 and 33.4mmol/L group was significantly higher than the 12.2 ～ 22.4mmol/L group( P ＜ 0.05 ) The inducement of MOF were infection (76.6％ ) medication terminate ( 9.4％ ),ketoacidosis ( 7.8％ ),cardiovascular and cerebrovascular accidents (6.3％ ).Conclusion Positive control of blood glucose in the early stage of diabetes,prevent complications,eliminate the incentive could reduce the incidence of MOF,eventually reduce the mortality rate.