62例重型颅脑伤患者选择性脑亚低温治疗期间的温度控制

目的探讨重症颅脑伤患者亚低温治疗期间的温度控制及其临床意义。方法对62例重型颅脑伤患者进行选择性脑亚低温治疗,温度设定为33℃～35℃;同时持续静脉滴注冬眠肌松剂,给予呼吸机辅助呼吸。冬眠肌松剂成分:500ml生理盐水+氯丙嗪100mg+异丙嗪100mg+卡肌宁200～400mg。经4～12h患者脑温降至33℃～35℃,维持2～10d。采用自然复温,患者经10～12h恢复正常体温。结果本组存活38例(61.29%),死亡14例(38.71%),38例存活者中治愈30例,好转5例,植物状态3例。结论亚低温治疗是重症颅脑伤患者重要治疗方法之一,能显著减轻脑损伤后神经功能障碍和脑病理形态损害,保护血脑屏障功能,从而明显降低重型颅脑伤患者的病死率,改善预后。

Objective To evaluate patients with severe traumatic brain injury during treatment with the hypothermia temperature control and its clinical significance. Methods 62 cases of severe traumatic brain injury selective cerebral hypothermia, the temperature set at 33 ℃ -35 ℃at the same time continuous infusion dormant muscle relaxants, support for ventilator-assisted breathing. Dormant muscle relaxants ingredients：500 ml saline ＋ Chlorpromazine Hydrochloride 100 mg ＋ Promethazine 100 mg ＋ Atriqcium 200 - 400 mg. After 4 - 12 h the patients brain temperature dropped to 33℃~ 35 ℃, and the maintenance of 2 ~ 10 days. The temperatures of the patients by natural rewarming resume normal body temperature after 10 - 12 hours. Results The 38 patients survived（61.29% ） , 14 patients died （ 38.71% ） , 38 cases of survivors cured were 30 cases, improved were 5 cases ,3 cases vegetative state. Conclusion Hypothermia treatment is an important method in patients with se- vere traumatic brain injury which can significantly reduce brain damage nerve dysfunction and brain damage pathological patterns, the protection of the blood-brain barrier function, significantly decreased in patients with severe traumatic brain injury mortality, improving prognosis.