ABSTRACT
Objective:To explore the risk factors its predictive value of delayed traumatic intracranial hematoma (DTICH) . Methods:Clinical data of 95 patients with acute craniocerebral trauma were collected .All patients were divided into DTICH group (n=62) and no recurrent hematoma control group (n=33) .Clinical data were compared between two groups ,Lo‐gistic regression model was used to analyze risk factors .Receiver operator characteristic curve (ROC) was used to assess pre‐dictive value of relative risk factors .Results:Compared with no recurrent hematoma group ,there were significant rise in age [(46.72 ± 6.45) years vs .(52.18 ± 7.13) years] ,hematoma volume [(51.21 ± 11.25)ml vs .(56.89 ± 12.37)ml] , level of fasting blood glucose [(8.13 ± 1.55) mmol/L vs .(10.62 ± 1.73) mmol/L] ,activated partial thromboplastin time [APTT ,(25.27 ± 6.19)s vs .(27.35 ± 7.45)s] and thrombin time [TT ,(17.53 ± 5.14)s vs .(21.26 ± 7.31)s] ,significant increase in percentages of basal cistern compression (24.2% vs .46.8% ) ,brain contusion (42.4% vs .69.4% ) ,bone flap removal (45.5% vs .67.7% ) and positive Babinski sign (39.4% vs .61.3% ) , and significant reductions in GCS score [(9.46 ± 3.29) scores vs .(7.63 ± 3.07) scores] ,systolic blood pressure [(146.57 ± 18.23)mmHg vs .(132.18 ± 17.18) mmHg] and timing of surgery [(12.74 ± 4.39)h vs .(5.47 ± 2.16)h] in DTICH group ,P<0.05 or <0.01;Logistic regres‐sion analysis indicated that coagulation function (APTT ,TT) ,skull fracture and timing of surgery were risk factors for post‐operative delayed hematoma(OR=4.076~5.430 ,P<0.05 or <0.01) ,their area under curve of ROC were 0.826 ,0.748 and 0.661 respectively .Conclusion:Coagulation function ,skull fracture and timing of surgery are risk factors and possess considerable predictive value for postoperative delayed craniocerebral hematoma in patients with craniocerebral trauma .
ABSTRACT
Objective To evaluate the effect of edaravone on moderate and severe brain injury patients by observing the change of the serum neuron-specific enolase ( NSE) and S100β protein. Methods A total of 90 patients with acute moderate and severe brain injury were selected and randomly divided into three groups, ie, control group (Group A), postoperative edaravone treatment group (Group B) and preoperative edaravone treatment group (Group C), 30 patients per group. In the meantime, 20 normal persons were set as the healthy control group. The concentrations of serum NSE and S100β protein of each group was measured by using the enzyme-linked immunosorbent assay ( ELISA) on admission and at days 1,3,5 and 7 after operation. Results The serum NSE and S100β protein levels in the Group A, B and C was higher than that in the healthy group on admission and at days 1,3,5 and 7 postoperatively and reached the peak at day 1 after operation (P ＜0.05). The level of serum NSE and S100β protein in the Group C was lower than that in the healthy group, Group A and Group B at day 1 postoperatively (P＜0.05), with no statistical difference between Group B and Group A at day 1 postoperatively (P ＞0.05). The serum NSE and S100β protein levels in the Group C was lower than that in the Group A at days 3, 5 and 7 postoperatively (P ＜0.05). The serum NSE and S100β protein levels in the Group C with severe brain injury was lower than that in the Group B at days 3, 5 and 7 postoperatively (P ＜ 0.05), but there was no statistical difference in moderate injury group between Croup C and Group B. The serum NSE and S100β levels in the Group B was lower than that in the Group A at days 3, 5 and 7 postoperatively ( P ＜ 0. 05). Conclusions Edaravone can effectively reduce the serum NSE and S100β levels in the moderate and severe brain injury patients after operation. The earlier use of edaravone may beget the more significant effect, especially in patients with severe brain injury. The application of edaravone before operation can more effectively reduce the concentration of serum NSE and S100β protein.