亚低温血液滤过对重症脑损伤脑血流动力学的影响

Effects of Mild Hypothermia Hemofiltration on Cerebral Blood Flow in Severe Brain Injuries

目的观察亚低温血液滤过对重型颅脑损伤患者脑血流(CBF)及颅内压(ICP)的影响。方法选择重型脑损伤患者65例,分为对照组(n=30)与观察组(n=35)。对照组采用常规治疗;观察组采用常规治疗加亚低温血液滤过治疗。应用经颅多普勒(TCD)监测CBF,应用ICP监护仪监测ICP。每天进行格拉斯哥昏迷(GCS)评分。结果治疗5 d后,观察组GCS评分高于对照组(P<0.05),CBF高于对照组(P<0.05),ICP明显低于对照组(P<0.01)。结论与传统降温疗法相比,亚低温血液滤过能够改善重症颅脑损伤引起的CBF紊乱,降低ICP,改善预后。

Objective To observe the effects of mild hypothermia hemofiltration on cerebral blood flow（CBF） and intracranial pressures（ICP） in patients with severe brain injury.Methods 65 patients with severe brain injuries were divided into control group（n=30） and observation group（n=35）.The control group accepted the routine treatment only while the observation group accepted mild hypothermia hemofiltration additionally.CBF was detected by Transcranial Doppler（TCD） and ICP was monitored by ICP monitor.Glasgow Coma Scale（GCS） was assessed every day.Results 5 d after treatment,the scores of GCS were higher in the observation group than in the control group（P〈0.05） as well as the CBF（P〈0.05）,but the ICP was in the observation group significantly lower than in the control group（P〈0.01）.Conclusion Compared with the traditional mild hypothermia,mild hypothermia hemofiltration can improve hemodynamic changes caused by severe brain injury,reduce ICP and improve the outcomes.