亚低温治疗重型颅脑损伤的疗效观察

Study of clinical effect of mild hypothermia on patients with severe head injury

目的研究亚低温对重型颅脑损伤患者的治疗效果。方法49例患者随机分为亚低温治疗组和对照组,亚低温治疗组25例,均于伤后24 h内进行亚低温治疗,直肠温度(RT)为32.0～35.0℃,脑温度为33.0～35.0℃,持续1～7 d。同时监测患者的生命体征、颅内压(ICP)及血糖变化。对照组24例采取常规治疗方法,降温但未使用冬眠疗法。结果亚低温治疗组与对照组相比,治疗组患者伤后早期高ICP、高血糖血症分别显著下降(P<0.05);无严重并发症,病死率低,预后显著改善。结论亚低温具有一定的脑保护作用,用于治疗重型颅脑损伤患者,可降低病死率,减少并发症,提高生存质量。

Objective To study the clinical effect of mild hypoithermia on patients with severe head injury. Methods All 49 patients with severe head injury were randomly divded into the hypothemic group and the control group. Hypothermia was induced within 24 hours of injury. Rewarming was begun on 1 -- 7 days after the rectal temperature（RT） reached 32.0- 35.0℃. Meantime, the vital sign, intracranial pressure, blood glucose change, blood electrolytes and brain tissue temperture were observed. Results In comparison with control group,during mild hypothermia increased ICP, hyperglycemia, raised blood lactate significantly decreased and cerebral flow improved dominantly（P 〈 0.05）. Conclusion Mild hypothermia is safe and effective for preventing brain damage of the patients with severe head injuey,which can reduce the the mortality and improve the prognosis.