过度通气与常规降颅压治疗对小儿颅内高压症的疗效比较

Comparison of Controlled Hyperventilation and Routine Antihypertension Therapy for the Treatment of Intracranial Hypertension in Children

目的探讨控制性过度通气治疗小儿颅内高压症的临床疗效。方法选择60例颅内高压患儿随机分为两组,治疗组在常规治疗基础上采用控制性过度通气治疗,对照组仅用常规治疗。观察两组患儿的颅内压降低情况、血浆CRP含量、临床症状缓解时间、治疗有效率及预后等,比较两种治疗方法的差异。结果两组患儿治疗前颅内压、血浆CRP含量显著增高,组间比较无显著性差异;治疗后颅内压值较治疗前明显下降,治疗组较对照组下降更显著(P<0.05)。比较两组抢救成功的患儿治疗后临床症状缓解时间,治疗组恢复时间短于对照组(P<0.05)。治疗组有效率明显高于对照组,后遗症的发生率明显低于对照组,两组比较亦有显著性差异(P<0.05)。结论控制性过度通气对于颅内高压症的治疗效果显著,临床症状缓解迅速,能够有效地改善病人的临床预后,减少致死致残率。

Objective To explore the clinical effects of controlled hyperventilation for the treatment of intracranial hypertension in children. Methods Sixty children with intracranial hypertension from three hos- pitals were enrolled, who were divided into therapy group and control group, 30 patients for each. The children of control group were treated with routine antihypertensive measurement, while the children of therapy group were treated with regular antihypertensive measurement and hyperventilation. The prognosis of intraeranial hy- pertension was evaluated by the level of intraeranial pressure reduction, serum CRP levels, effective rate, disa- bility rate and the clinical response time. Results Before the treatment, the intraeranial pressure and the se- rum CRP levels of the children in two groups increased significantly, and there was no significant difference be- tween the two groups. In the therapy group, the post-therapie reduction level of intraeranial pressure and the se- rum CRP dropped significantly comparing with the control group （P 〈 0.05 ）. The clinical response time of therapy group was shorter than the control group （ P 〈 0.05 ）. The disability rate decreased significantly and the effective rate increased significantly in the therapy group（ P 〈 0.05 ）. Conclusion It shows rapid effects of the controlled hyperventilation for intraeranial hypertension, and it can improve the clinical outcomes and reduce the morbidity.