亚低温对重型颅脑损伤患者脑实质压力的影响

Effects of therapeutic mild hypothermia on cerebral hemisphere pressure after severe traumatic brain injury

目的研究亚低温治疗对重型颅脑损伤患者脑实质压力的影响。方法选择确诊重型颅脑损伤患者14例,入院后分别于两侧额部钻颅置入光导纤维传感器行两侧大脑半球脑组织压(brain parenchyma pressure,BPP)监护,术后给予亚低温治疗,分别于不同时间点收集两侧大脑半球BPP数据,并行配对对照。结果术前监测的两侧BPP差异有统计学意义(P<0.01)。术后24 h、48 h、72 h不同时间点监测的两侧BPP差异均无统计学意义(P>0.05)。术后两侧脑实质压力均比术前明显下降,亚低温治疗后,患者两侧脑实质压力差基本消失。结论亚低温治疗能有效降低两侧脑实质压力差,改善预后。

Objective To investigate the effects of therapeutic mild hypothermia on cerebral hemisphere pressure after severe traumatic brain injury （TBI）. Methods Fourteen patients with TBI were included in this study. All patients received brain parenchyma pressure （BPP） monitoring by introduction of an optical fiber sensor into each cerebral hemisphere via the frontal lobe, and then they were treated with therapeutic mild hypothermia. Preoperative and postoperative BPP data at different time points were recorded and analyzed. Results Preoperative BPP value of the injured hemisphere was significantly higher than that of the normal hemisphere （P 〈 0.01 ）. There was no significant difference of BPP value at three postoperative time points between two hemispheres （ P 〉 0.05 ）. The Postoperative hemisphere BPP values were lower than the preoperative ones. The difference of BPP value between two hemispheres disappeared after therapeutic mild hypothermia treatment. Conclusion Therapeutic mild hypothermia can effectively reduce the difference of BPP value between two hemispheres and improve the prognosis.