局部亚低温治疗高血压脑出血术后患者的临床研究

Clinical study of local mild hypothermia on postoperative patients with hypertensive intracerebral hemorrhage

目的观察局部亚低温对高血压脑出血术后患者的治疗效果。方法60例高血压脑出血微创术后患者随机分为2组,对照组30例给予常规药物治疗,亚低温组30例在常规药物治疗基础上加用局部亚低温治疗,观察血糖、大脑中动脉平均血流速度(Vm)、脉动指数(PI)、临床神经功能缺损评分、Barthel指数(BI)变化及并发症发生率。结果与对照组比较,亚低温组血糖水平、血肿侧PI、应激性溃疡发生率、临床神经功能缺损评分均明显降低(P<0.05),血肿侧Vm、BI评分明显增加(P<0.05)。结论局部亚低温治疗可降低高血压脑出血术后患者的应激反应,改善脑血流动力学,具有明显脑保护作用。

Objeetive To investigate the effects of local mild hypothermia on postoperative patients with hypertensive intracerebral hemorrhage （HICH）. Methods After minimally invasive hematoma removed, 60 patients with HICH were divided into control group （30 cases, treated with routine medication） and hypothermia group （30 cases, besides routine medication, local mild hypothermia therapy performed）. Blood glucose, mean blood flow velocity （Vm） of middle cerebral artery （MCA）, pulsatility index （PI）, neurological function deficiency score, Barthel index （BI） score and complications in the two groups were observed. Results Compared with control group, the blood glucose level, PI from hemorrhagic hemisphere, incidence of stress ulcer, neurological function deficiency score decreased significantly （P〈0. 05）, and Vm from hemorrhagic hemisphere, BI score increased significantly （P〈0.05） in hypothermia group. Conclusion Local mild hypothermia could decrease the stress reaction, improve the cerebral homodynamic and the prognosis of postoperative patients with HICH.