Efficacy of a trauma-integrated treatment program for severe traumatic brain injury and its effect on patients' coagulation and neurological functions
10.3760/cma.j.cn341190-20231215-00576
- VernacularTitle:创伤一体化救治方案用于重度创伤性颅脑损伤的效果及对患者凝血功能与神经功能的影响
- Author:
Guohao CHEN
1
;
Laifa KONG
;
Yuping CAO
Author Information
1. 金华市中心医院创伤外科，金华 321000
- Keywords:
Craniocerebral trauma;
Clinical protocols;
Emergency treatment;
Prothrombin time;
Thrombin time;
Prognosis
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(9):1316-1321
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of a trauma-integrated treatment program for severe traumatic brain injury and its effect on patients' coagulation and neurological functions.Methods:A total of 114 patients with severe traumatic brain injury who received treatment at the Department of Trauma Surgery at the Jinhua Municipal Central Hospital from April 2020 to October 2022 were retrospectively included in this study. The patients were divided into two groups based on different treatment protocols: Group A ( n = 57 patients) received the conventional emergency treatment protocol, while Group B ( n = 57 patients) received the trauma-integrated treatment protocol. The emergency treatment efficiency (including emergency room stay time, waiting time for auxiliary examinations, waiting time for multidisciplinary consultations, and time from emergency to surgery), coagulation function (prothrombin time, thrombin time, activated partial thromboplastin time), neurological function (National Institutes of Health Stroke Scale), incidence of complications (stress ulcers, pulmonary infections, hypernatremia, and cerebral salt-wasting syndrome), and prognosis were compared between the two groups. Results:The emergency room stay time, waiting time for auxiliary examinations, waiting time for multidisciplinary consultations, and time from emergency to surgery in Group B [(21.94 ± 6.21) minutes, (5.78 ± 1.12) minutes, (10.58 ± 2.47) minutes, and (8.57 ± 2.01) minutes] were significantly shorter than those in Group A [(32.59 ± 6.83) minutes, (9.46 ± 2.57) minutes, (17.36 ± 3.71) minutes, (15.36 ± 4.49) minutes, t = 8.71, 9.91, 11.48, 10.42, all P < 0.001]. After treatment, the prothrombin time, thrombin time, and activated partial thromboplastin time in Group B [(19.78 ± 2.32) seconds, (21.16 ± 2.60) seconds, (39.35 ± 4.60) seconds] were significantly shorter than those in Group A [(21.83 ± 2.63) seconds, (23.28 ± 2.95) seconds, (42.16 ± 5.52) seconds, t = 4.41, P < 0.001, t = 4.07, P < 0.001, t = 2.95, P = 0.002]. The National Institutes of Health Stroke Scale score after treatment in Group B [(13.55 ± 3.17) points] was significantly lower than that in Group A [(18.36 ± 3.83) points, t = 7.30, P < 0.001]. The incidence of complications in Group B [7.02% (4/57)] was significantly lower than that in Group A [22.81% (13/57), χ2 = 5.60, P = 0.018]. The rate of good prognosis in Group B [66.67% (38/57)] was significantly higher than that in Group A [47.37% (27/57), χ2 = 4.33, P = 0.037]. Conclusion:The trauma-integrated treatment protocol is effective for severe traumatic brain injury, as it improves emergency treatment efficiency, enhances coagulation and neurological functions, reduces the incidence of complications, and is beneficial for prognosis.
