亚低温治疗老年急性重度颅脑损伤患者的神经功能改善及血流动力学改变分析

Improvement of nerve function and hemodynamic changes in patients with acute severe craniocerebral injury in elderly patients treated with mild hypothermia

目的：研究亚低温治疗老年急性重度颅脑损伤患者的神经功能改善及血流动力学改变。方法：选择2012-05-2015-07我院接诊的92例老年急性重度颅脑损伤患者进行研究,随机分为观察组和对照组,每组各46例。对照组给予常规治疗,观察组采用亚低温治疗。观察组患者进行24~72h的亚低温治疗。对比分析2组患者神经功能评分（GCS）和血流动力学评分情况,并记录不良反应发生情况。结果：2组患者颅脑损伤和临床特征情况比较差异无统计学意义;2组患者的收缩期血流速度（Vs）、平均血流速度（Vm）和搏动指数（PI）在1d的时候无明显变化,在之后3d、5d、10d观察组的Vs、Vm和PI和对照组相比较有较明显改善,2组比较差异有统计学意义（P〈0.05）;2组患者的GCS评分在1d和3d并无明显差异,但在5d、7d观察组GCS评分要明显好于对照组,在10d达到最高（10.43±3.33）分vs.（8.23±3.23）分,2组比较差异有统计学意义（P〈0.05）。2组不良反应发生率差异无统计学意义。结论：亚低温治疗老年急性重度颅脑损伤患者效果良好,可以显著改善患者的血流动力学指标,对患者的脑组织具有一定的保护作用,值得在临床推广和应用。

Objective：To study the improvement of nerve function and hemodynamics in elderly patients with acute severe brain injury by mild hypothermia.Method：Ninty-two elderly patients with traumatic brain injury from May 2012 to July 2015 in our hospital were enrolled in this study.According to the random number table method,they were randomly divided into experimental and control group,46 patients for each group.In the control group,patients were treated with conventional treatment.And inthe observation group patients were treated with mild hypothermia for 24~72h.Hemodynamics and GCS score situation were comparative in the two groups of patients.And the incidence of adverse reactions in two groups were record.Result：Cranial trauma and clinical characteristics in the two groups of patients was not statistically different;compared two groups,Vs,Vm and PI in 1dwere no significant change.After 3d,5d,10 dVs,Vm and PI in observation group displayed a more significant improvement compared to the control group（P〈0.05）;compared two groups of patients,GCS score in the 1dand 3ddid not differ significantly,but in 5d,7dobservation group GCS score was significantly better than the control group,and there was a most significant difference in the 10d（10.43±3.33）min vs.（8.23±3.23）min.The adverse reactions of the two groups had no significant difference.Conclusion：Hypothermia treatment of elderly patients with acute severe brain injury is good,can significantly improve the hemodynamics of the patient,the patient＇s brain tissue has a protective effect,it should be popularized and applied in clinical practice.