重症脑损伤的亚低温治疗及监护

Mild Hypothermia therapy and Monitoring of Severe Brain Damage

目的 探讨亚低温对不同原因重症脑损伤的确切疗效及亚低温对机体免疫功能、凝血功能的影响。方法 亚低温治疗组共78例。发病后24h内行亚低温治疗,设定治疗温度为肛温33～35℃。对照组84例,于发病后1～3月按GOS评定预后。结果 亚低温组死亡率均有明显下降,亚低温组病人体液免疫、凝血功能与对照组无差异。结论 亚低温对外伤性和出血、缺血引起的脑损伤均有明显疗效,亚低温期机体免疫、凝血功能不受影响。

Objective To evaluate the effectiveness of mild hypothemia on patients with severe brain damage, and its effects on the irnmunological and blood coagulation functions of these patients. Methods Retrospective analysis was conducted for data of 78 patients with severe brain damage. All of them recieved mild hypothermia treatment (the rectal temperature maintained at 33-35℃) for an average period of 4.7 days 24 hours after the brain damage. Another 84 patients served as control. GOS was used for the assessment of prognosis in these 2 groups. Results Final results demonstrated that, the mortality was significantly lower in the treatment group than that in the control group, but there was no obvious difference befween these two groups both in irnmunological and blood coagulation functions. Conclusions Mild hypothermia therapy has significant effect on the treatment of the severe brain danage caused either by trauma, hemorrhage or ischemia. The irnmunological and blood coagulation mechanisms are not affected during the hypothermic treatment.