亚低温治疗临床重型颅脑损伤的疗效分析

Clinical effect of mild hypothermia on patients with severe brain injury

目的探讨亚低温治疗临床重型颅脑损伤患者的作用及疗效。方法选择新疆医科大学第六附属医院神经外科2004年4月-2012年4月收治的急性重型颅脑损伤[格位斯哥昏迷评分(GCS)≤8分]患者92例,随机分为对照组和亚低温组,每组各46例,对照组给予常规脱水降低颅内压治疗,亚低温组在常规治疗基础上行亚低温治疗,根据GCS评分对患者6个月时的神经系统功能进行评分,治疗过程中记录并发症的发生情况,包括电解质紊乱、肺部感染、肾功能衰竭、消化道应激性溃疡及心律失常等。结果 6个月时,亚低温组的神经系统评分恢复良好率为63.0%,明显优于对照组的26.1%,差异有统计学意义(P<0.05);亚低温组死亡率为8.7%,明显低于常温组的28.3%,差异有统计学意义(P<0.05)。两组并发症发生率无明显差异(P>0.05)。结论亚低温治疗重型颅脑损伤安全有效、便于实行,可明显改善病人的预后,值得临床推广应用。

Objective To investigate the treatmeng of mild hypothermia in severe head injury patients and the role of treatmeng efficacy. Methods There were 92 cases from Apirl 2004--Apirl 2012 in the Depart ment of Neurosurgery in the Sixth Affilited Hospital of Xinjiang Medical University. The patients with se vere injury Eglasgow coma scale （GCS） of 8 or less on odmission] were randomly divided into the hypot hermie grorp （46 cases） and the control group （46 cases）. The control group was given routine dehydra tion reduces intracranial pressure and other treatment, treatment of mild hypothermia treatment foundation to mild hypothermia group was given conventional go up, according to the GCS score of patients dur ing the first 6 months of the neurological score, recorded complications during treatment including electro lyte disorders, lung infection, renal failure, gastrointestinal stress ulcer and arrhythmia occurrence. Resuits Compared the GCS score in patients 6 months, good recovery rate of hypothermia group （63%） was significantly better in the control group （26.1%）, the difference was statistically significant （P 〈0.05） ; Mortality rate in mild hypothermia group （8.7%） was significantly lower in the control group （28.3%）, the difference was statistically significant （P 〈0.05） ; Two groups had no significant difference in complication rate （P 〉0.05）. Conclusion Mild hypothermia is safe and effective for preventing brain damage of the patients with severe nead injury, which can improve the prognosis. It is worth to use in clinic.