用诱发电位检测亚低温对高温高湿环境下特重型颅脑伤的疗效

Effect of Mild Hypothermia on Evoked Potential in Patients with the Mest Severe Brain Injuries in a Hot and Humid Enviroment

目的 通过诱发电位（EP）监测，探讨亚低温对高温高湿环境下特重型颅脑伤的疗效。方法 选择受伤后在高温高湿环境下（≥32℃，RH≥80％）8h内入院的特重型颅脑伤患者（GCS≤5）60例．患者随机分为亚低温组（n=30）和常温组（n=30）。亚低温组体温降至33～35℃．于降温前、降温过程中及复温后监测正中神经短潜伏期体感诱发电位（SLSEP）和脑干听觉诱发电位（BAEP）：常温组在同样的时间段监测上述指标。统计分析亚低温组与常温组诱发电位的变化情况。结果 亚低温组在治疗后SLSEP的N20波同变化值为（0．87±0．52）μV，常温组为（0．61±0．49）μV，两者有显著性差异（P〈0．05）：BAEP的V／I波幅比值，差异显著性（P〈0．05）。结论 从神经电生里角度来看，亚低温对GCS为3～5分的高温高湿环境下特重型颅脑伤有较好疗效。

Objective To investigate the effect of mild hypothermia on the patients with most severe brain injuries evaluated by means of evoked potentials . Methods Sixty Patients with the most severe brain injuries （GCS≤5） in a hot and humid enviroment（atmospherict emperature≥32 ℃, relative humidity≥80% ） ,who were admited to the Hospital within 8 hours after the injury,were selected for this study. The patients were randomly divided into hypothermia and normothermia groups. The patients in the hypothermia group were treated by mild hypothermia（ 33 ～35℃ ）. Median nerve short latency somatosensory evoked potentials （SLSEP） and brain stem auditory evoked potentials（BAEP） were recorded before and after the treatment in both the hypothermia and normothermia groups. The changes in the evoked potentials were analysed statistically. Results The changs in N20 amplitudes in the hypothermia group and normothermia group were （ 0. 87 ± 0. 52 ） μv and （ 0.61 ± 0. 49 ） μv respectively during the treatment. There were significant differences in the N2O amplitade of SISEP and ratio of V/I amplitudes of BAEP between both the groups（ P 〈0.05 ）. Conclusion It is demonstrated that the curative effect of mild hypothermia on patients with the most severe brain injury in a hot and humid enviroment is good effective.