高血压脑出血术后患者亚低温治疗疗效观察

The observation of curative effect on postoperative patiens with hypertensive cerebral hemorrhage applying the hypothermia treatment

目的与常温下治疗高血压脑出血术后患者临床效果相比较,探讨亚低温对患者的临床效果。方法选取100例高血压脑出血术后患者,分为亚低温组(50例)和常温对照组(50例),亚低温组术后开始用冰毯机持续降温,维持体温32℃～35℃。配合应用冬眠、镇静、解痉等措施,治疗时间为5～7d。对照组患者给予常规治疗,措施与亚低温组相同。两组患者伤后当天及第1,3,5,7天行头颅CT扫描检查,动态观察损伤脑组织的影像学变化,并作预后分析。结果治疗后3～6个月后,亚低温组恢复良好率为19/50(38%),死亡率4/50(8%)。对照组恢复良好率为12/50(24%),死亡率7/50(14%)。两组比较,差异均有显著性意义(P<0.01)。结论亚低温治疗可以降低高血压脑出血手术患者的死亡率,改善预后,是治疗高血压脑出血患者的有效辅助方法。

Objective Compared with the treatment on the patient of hypertensive cerebral hemorrhage at normal temperature,to discuss the curative effect of cerebral protection with hypothermia to treat postoperative patiens with hypertensive cerebral hemorrhage.Methods A total of 100 patients of hypertensive cerebral hemorrhage were collected for study.Each case was applied with craniamphitom hematoma clear operation within one week after admission.All the patients were divided into two groups：hypothermia group （50 cases）and normal temperature group（50 cases）.The patient in the hypothermia group keep the body temperature at 32～35℃ after operation,the method is to apply with cooling blanket and hibernation drugs,breathing apparatus and muscle relaxants when necessary.The patient in the control group was given conventional treatment which the same as hypothermia group.Each case was scanned by CT on days 1,3,5,and 7.Dynamic observation on the imaging changes of damaged brain and to analyze the prognosis.Results 3～6 months after treatment,in the hypothermia group,34 patients had a good recovery（38%）,6 patients died（8%）.In room temperature group,24 patients had a good recovery（24%）,14 patients died（ 14%）.The difference between the two groups have a high degree of statistical significance（P0.01）.Conclusion Hypothermia can reduce the rates of mortality on postoperative patiens with hypertensive cerebral hemorrhage,it is an effective method for serious brain injury.