头部低温治疗高血压性脑出血高热的最佳疗程的研究

Research of the Treatment Time of Head Hypothermia on Hyperthermia after Hypertensive Intracerebral Hemorrhage

目的探讨头部低温对高血压性脑出血(HIH)高热降温最佳治疗时间.方法 176例HIH高热病人随机分为四组,A组43例,为体温恢复后(≤37.5℃)即停止头部低温治疗者;B组44例,为体温恢复后头部低温继续治疗1～2 d者;C组51例,为3～4 d者;D组38例,为5～6 d者.结果四组比较,头部低温启始时间、体温恢复时间及3天体温恢复率均无显著性差异(P＞0.05);体温再发率以A、B两组最高(P＜0.05);治疗前后神经功能缺损评分(NDS)、日常生活质量评分(ADL)比较,以C、D组效果最佳(P＜0.05).结论头部低温降温治疗时间为体温恢复后继续治疗3～4 d者最佳.

Objective To probe the best time treating hyperthermia after hypertensive intracerebral hemorrhage （HIH） with head hypothermia. Methods According to the head hypothermia treatment time, a total of 176 cases of HIH patients were randomly divided into four groups：Group A （n=43） including the cases stopping treatment soon after body temperature recovering, group B （n= 51） involving the cases continuing treatment for 1 or 2 days, group C （n=38） being for 3 or 4 days and group D （n=38） being for 5 or 6 days. Results All of the four groups, there were no significant difference when comparing the beginning time of head hypothermia, the body temperature recovering time and the rate of body temperature recovery （P 〉 0.05）, respectively. Group A and B had the highest recurrence of hyperthermia, and the group C and D had the best treatment effect according to comparison of neurological deficit scores （NDS） and activity daily living （ADL） before and after treatment （P 〈 0.05）. Conclusions The optimized time of head hypothermia treatment on HIH is continuing treatment for 3 or 4 days after body temperature recovering.