亚低温治疗重型颅脑损伤的疗效观察和临床护理

Therapeutic effect on severe head hypothermia and dinical nursing injury with mild

目的探讨亚低温对重型颅脑损伤（SHI）的治疗效果及护理方法。 方法选择受伤后6h人院的SHI患者46例（GCS≤8分）．随机分成治疗组和对照组各23例．其中治疗组采用物理降温与冬眠肌松剂相结合．进行全身降温．设肛温为33-350℃．时间5～12d，观察患者的生命体征、颅内压（ICP）、血糖及预后情况。对照组按常规治疗及护理。 结果治疗组ICP及血糖控制明显优于对照组，且治疗组死亡率明显下降．好转率明显提高，但体液免疫、凝血功能与对照组无差异。 结论亚低温治疗SHI有明显疗效。护理要点是严密观察病情变化，做好低温控制和监护及生活护理．减少并发症，确保亚低温治疗的实施。

Aim To approach the mild hypothermia＇s therapy and nursing to severe head injury. Methods 46 Severe head injury patients were selected, who was admitted to hospital after being injured for six hours （GCS≤8 scores）, 46 patients were divided into two groups ： mild hypothermia therapy group （23cases） and control group （23cases） . Patients in experinaental group were given mild hypothermia therapy and hibernation and Skelaxin to progressing total body hypothermia , and set up rectal temperature as 33-35℃. The therapy lasted 5-12 d. We observed the vital signs, intracranial pressure （ICP）, blood glucose and the prognosis condition of the patients. Patients in control group were given routine nursing only. Results The intracranial pressure and blood glucose of experimental group was obviously better than control group＇s; the death rate in experimental group was obviously decreased; and improvement rate was also elevated. The humoral immunity and blood clotting function of mild hypothermia therapy group had no difference to the control group. Conclusions Mild hypothermia therapy has obviously curative effect to the heavy cerebral trauma. The main points of nursing was observing the changes of pathogenetic condition closely, attenting the control and guardianship of hypothermy. We should make the life nursing nice so that we can decrease complications and ensure the practice of hypothermy therapy.