稳定较低体温治疗重型颅脑损伤临床分析

Clinical analysis of keeping lower temperature in treatment of severe traumatic brain injury

目的探讨稳定较低体温疗法治疗重型脑颅损伤的效果。方法将163例重型颅脑损伤(GCS≤8分)患者分为3组:(1)稳定较低体温组(55例),将体温控制在35～36℃;(2)亚低温组(54例),体温控制在33～34℃;(3)对照组(54例),给予常规治疗。结果稳定较低体温组预后良好率为52.7%(29/55),死亡率为20.0%(11/55);亚低温组良好率为50.0%(27/54),死亡率为22.2%(12/54);对照组良好率为22.2%(12/54),死亡率为33.3%(18/54);稳定较低体温组的良好率与亚低温组相比,差异无统计学意义(P>0.05),但显著高于对照组(P<0.05)。稳定较低体温组与对照组总并发症发生率比较,差异无统计学意义(P>0.05),但与亚低温组比较,差异有统计学意义(P<0.05)。结论稳定较低体温疗法治疗重型颅脑损伤能明显提高患者恢复良好率,并且并发症总发生率明显低于亚低温组,是治疗重型颅脑损伤安全有效、便于操作的方法之一,容易在县级基层医院开展。

Objective To investigate the effect of keeping lower temperature in treatment of severe traumatic brain in- jury. Methods One hundred and sixty-three cases of patients with severe traumatic brain injury （GCS ≤ 8） were di- vided into 3 groups： （1）keeping lower temperature group （55 cases）, the body temperature were controlled over 35-36℃; （2）mild hypothermia group （54 cases）, the body temperature were controlled over 33-34℃; （3）control group （54 cases）, they were treated with conventional treatment. Results The prognosis of keeping lower temperature group was 52.7% （29/55） in good rate, 20.0% （11/55） in mortality rate. In mild hypothermia group, the good rate was 50.0% （27/54）, the mortality rate was 22.2% （12/54）. In the control group, the good rate was 22.2% （12/54）, the mortality rate was 33.3% （18/54）. There was no significant difference in the good rate between keeping lower temperature group and mild hy- pothermia group （P 〉 0.05）, but the good rate of keeping lower temperature group was significantly higher than that of control group （P 〈 0.05）. Compared with control group, the total complication rate of keeping lower temperature group had no significant difference （P 〉 0.05）; but compared with mild hypothermia group, they were significantly different （P 〈 0.05）. Conclusion The method of keeping lower temperature can improve the recovery rate of severe traumatic brain injury patients, and the total complication rate is significantly lower than that in mild hypothermia group. So it is one of the safe effective and easy-to-use methods in treatment of severe traumatic brain injury, it can be carried out easily in the county level primary hospital.