亚低温治疗急性重型颅脑损伤40例

Study of Clinical Effect of Mild Hypothermia on Severe Head Injury in 40 Cases

目的研究亚低温治疗急性重型颅脑损伤的临床疗效。方法将80例急性重型颅脑损伤患者随机均分为治疗组和对照组,治疗组于伤后24h内行亚低温治疗,控制肛温为32～35℃,持续2～6d,同时监测生命体征、颅内压、肾功能、血糖、血气及电解质;对照组控制肛温为36.5～37.5℃,其他治疗同亚低温组。两组患者伤后6个月根据格拉斯哥预后评分法评估疗效。结果与对照组比较,治疗组颅内压显著降低,恢复良好率显著提高,死亡率显著降低,预后显著改善(P<0.05),且并发症无增加。结论亚低温治疗急性重型颅脑损伤安全、有效,可显著降低死亡率,改善患者的预后。

Objective To investigate the clinical effect of mild hypothermia on the patients with severe head injury. Methods All 80 patients with severe head injury were randomly divided into the mild hypothermia group and the control group. Hypothermia was induced within 24 h of injury. The rectal temperature was controlled at 32 - 35 ℃ for 2 - 6 d. Meantime, the vital signs, intracranial pressure （ICP）, renal function, blood sugar, blood gas values, blood electrolytes were monitored. The rectal temperature in the control group was induced to 36.5- 37.5 ℃. According to Glasgow outcome scale（GOS）, the prognosis of the patients was evaluated. Results In comparison with the control group, ICP was significantly decreased, the good recovery rate increased, the mortality reduced and the prognosis improved obviously, but the complications were not increased. Conclusion Mild hypothermia is safe and effective for the patients with severe head injury, which can reduce the mortality and improve the prognosis.