亚低温治疗重症脑血管病疗效观察

Clinical observation of mild hypothermia treatment on severe cerebrovascular disease

目的 观察亚低温治疗重症脑血管病的疗效。方法 62例重症脑血管病患者 ,随机分为亚低温组和对照组 ,亚低温组应用冰毯机将患者肛温控制在 3 4～ 3 5℃达 48h ,并于治疗前、治疗开始后第 2天、第 5天、第 7天对两组患者进行格拉斯哥昏迷评分 (glasgowcomascale ,GCS) ,同时于治疗前、治疗开始后第 2周、第 4周、第 1 2周进行神经功能缺损评分 ,监测患者生命体征 ,记录治疗中出现的副反应及死亡率。结果 治疗组 3 0例患者治疗前及治疗后 2d、5d、7dGCS分别为 7.60、8.3 5、1 3 .3 9、1 4.2 7;对照组相应数值分别为 7.52、8.1 6、9.40、1 0 .1 8;治疗组治疗前及治疗后 2周、4周、1 2周神经功能缺损评分分别为45.2 7、3 5.79、1 7.3 6、1 4.1 2 ;对照组相应数值分别为 45.52、3 7.46、2 9.70、2 5.3 5;治疗组与对照组死亡率分别为 7.3 3 %和 2 8.1 2 % (P <0 .0 5)。两组治疗后第 5天、第 7天GCS相比较 ,治疗组明显好于对照组 (P <0 .0 5) ;两组治疗后第 4周、第 1 2周神经功能缺损评分相比较治疗组也明显好于对照组 (P <0 .0 5)。治疗组出现明显副反应。结论 亚低温治疗能有效保护重症脑血管病患者的脑细胞 ,降低死亡率 ,改善脑卒中患者的预后。

Objective To observe the effect of mild hypothermia treatment on severe cerebrovascular disease.Methods 60 cases with severe cerebrovascular disease were randomly assigned to hypothermia group and control group.In hypothermia group the patients were cooled to 34-35℃,in the control group the patients were treated by routine methods.In the hypothermia group,the Glasgow coma scores were measured before cooling,at 2 days,5 days,7 days,and the neurological function score was measured before cooling,at 2 weeks,4 weeks,12 weeks after cooling.The same score was measured at the same time in the control group,and the mortality rate in two group were recorded.Results The scores of GCS and neurological function were found significantly different between mild hypothermia group and control group.The mortality rate in hypothermia group and control group were 7.33 % and 28.12 % respectively(P< 0.05 ).Conclusions Mild hypothermia can offer neuroprotection for the patients with severe cerebrovascular disease,reduce their mortality rate,and improve their prognosis.