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NGHIEN Clill GIA TR| BACH CAU TRONG 24 Gid DAU

Of BENH NHAN CHAN THUONG SO NAO NANG

n g u y £ n v i£ t q u a n g . n g u y In v i£ t q u a n g hi£n

t 6 m t At

Ddt van de: Chan thuvng so ndo gay nen hien

tuong viem ngay sau khi chin thuong x&y ra. Co thS

ddp ung lai phdn ung viem ndy qua nhidu co ch6 thdn

kinh, th i dich. Ngodi ra cdn th iy tdng sd luong bach cau

ngay sau khi chdn thuong. Doi twang vd phirong

phdp nghien ciru: 120 bdnh nhdn chdn thuong so nao

ndng didu tri tgi Bdnh vien Trung uong Hud, tudi 2.18

Ket qud: 120 bdnh nhdn, nam 104, nu-16, 18-39 tudi cd

82 bdnh nhdn, 40-60 tudi cd 31 benh nhdn, tren 60 tudi

cd 7 bdnh nhdn. Nhdm Glasgow 3-6 diem c6 35 bdnh

nhdn, nhdm bdnh nhdn Glasgow 7-8 didm cd 85 bdnh

nhdn. Bach cdu d nhdm benh nhdn Glasgow 3-6 didm

Id (14,95±1,17)x103 vd nhdm Glasgow 6-7 diem Id

(12,02±1,95)x103. Ket ludn: Gid tri bach cdu cdng cao

thang diem Glasgow cdng thdp, tidn luong cdng ndng.

Tir khda: Chdn thuong so nao, Glasgow.

SUMMARY

RESEARCH OF WHITE BLOOD CELL VALUE AT

FIRST 24 HOURS IN PATIENTS WITH SEVERE

TRAUMATIC BRAIN INJURY

Background: Brain injury causing inflammation

immediately after the injury. The body responsed to this

inflammation through neural hormon mechanisms.

Another way, traumatic brain injury patients have elevated

white blood cell count immediately. Subjects and

methods: 120 patients with severe traumatic brain injury

treated at Hue Central Hospital, age a 18. Results: 120

patients, 104 males, 16 females, 18-39 years old: 82

patients, 31 patients 40-60 years old, >60 years old: 7

patients. Group Glasgow 3-6 points: 35 patients, Glasgow

7-8 points: 85 patients. White blood cell at Glasgow group

3-6 points: (14.95 ± 1.17)x103 and Glasgow group 7-8

points: (12.02 ± 1.95)x103. Conclusion: In patients with

traumatic brain injury, the higher of white blood cells is the

low Glasgow Coma Scale. High value of white blood cells

is the worse prognosis.

Keywords: Brain injury, Glasgow.

DAT VAN 0£

Chin th u ’O’ng so nao gay nen h id n tu ’a n g viem ngay

sau khi c h in th u a n g xay ra. Ca th e dap d n g lai phan

ung vidm ndy qua n h iiu ca che th in k in h , th e d ic h .

Ngo3i su tdng tiet cortisol, glucose, cac cytokine

viem nhir interteukin-6, tumor necrosis factor-a... ca

the cbn phan dng bing cach tdng s6 luang bach ciu

ngav sau khi chin thuang.

Cf nude ngodi dd c6 nhieu tec gia nghidn cdu vin

d l ndy nhung d Vidt Nam dang cbn d mdc khidm t6n.

Chung tdi nghidn cdu v in de ndy nhlm 2 muc

tidu: Xdc dinh gid tri bgch cdu d cdc bdnh nhdn chdn

thuong so ndo ndng.

Tim mdi lidn quan giCra bach cdu vdi dd ndng cua

chdn thuong s q ndo qua thang didm Glasgow.

odi TUCrNG VA PHirONG PHAP NGHIEN CLTU

1. Ddi tipang

- 120 bdnh nhdn bj chin thuang so ndo ndng

nhdp vien diiu tri tai Khoa Gdy md Hdi sdc A vd

Khoa Hoi sue c ip cdu Bdnh vidn Trung uang Hud

- Thdi gian nghidn cdu td 7/2012 ddn 12/2013.

1.1. Tieu chuan chon b$nh

- Tuoi td 18 trd Idn.

- Bi chin thuang so ndo ndng khdng hodc chua

c6 chi dinh phlu thudt.

- Glasgow s8 diem.

1.2. Tieu chuan loai tnr

- Benh nhdn <18 tu6i.

- Bi thuang t6n ndo nhung khdng do chin thuang

(u ndo, TBMMN).

- Bi chin thuang so ndo nhung cd Glasgow td 9

din 15 diem.

- Bi chin thuang so ndo ndng kdm theo nhdng

thuang tin trim trong khdc nhu ddp phii, vd tgng

ddc, chodng ndng.

2. Phipang phdp nghidn cdu

Md ta cdt ngang cd theo ddi vd ddnh gid k it qua

diiu tri.

k £t QUA

1. Tudi, gidi, chi sd sdng cdn (mach, huydt dp,

tin sd thd) luc nhdp vidn

1.1. Ddc diem ve tuoi

Tuoi n % P

18-39 82 68,33

40-60 31 25,83 <0,05

>60 07 5,84

ndng, tu ii < 40 chiim da s6.

1.2. Ddc diem gidn

Bang 2 Ode diem ve gidi

Giai n % P

Nam 104 86,66 <0,05 Ni> 16 13.34

■■ ■ i i i iq i i w i igii i u i u v / i i ^ o y n a u n a n g ,

nam gidi chiim 86,66%, nhiiu horn hdn nd gidi. Su

khdc biet cd y nghTa thing kd p<0,05.

1.3. Chi so song cdn

Bang 3. Chi sd sing cdn theo tu6i vd gidi

Mgch

lan/phut

HATB

(mmHg)

TST

lln/phut

Nam 89±23 76±13 23±05

NCr 86±18 73±15 21±08

18-39 tu6i 92119 79±23 26±10

40-60 tudi 90±25 77±16 21 ±09

>60 tu6i 88±22 72±22 25±09

P >0,05 >0.05 >0,05

khdc nhau khdng cd y nghla thdng kd. p>0.05.

56 Y HOC THI/C HANH (905) - SO 2/2014