亚低温治疗62例重症脑血管病

The Treatment of Severe Cerebrovascular Disease by Mild Hypothermia

目的 :观察重症脑血管病患者应用亚低温治疗的疗效。方法 :62例重症脑血管病患者 ,随机分为亚低温组 (n =3 0 )和对照组 (n =3 2 ) ,亚低温组应用冰毯机将患者肛温控制在 3 4～ 3 5℃ ,连续应用 4 8h。并于治疗前、治疗开始后第 2d、第 5d、第 7d对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 12周进行神经功能缺损评分 ,记录治疗中出现的副反应及死亡率。结果 :治疗组与对照组死亡率分别为 7.3 3 %和 2 8.12 % (P <0 .0 5 )。治疗后第 5d、第 7d的GCS ,治疗组明显好于对照组 (P <0 .0 5 ) ,神经功能缺损评分治疗组也明显好于对照组 (P <0 .0 5 )。治疗组无明显副反应。结论 :亚低温治疗能有效地保护重症脑血管病患者的脑细胞 ,降低死亡率 。

Objective: To observe the effect of mild hypothermia treatment on the patients with severe cerebrovascular disease. Methods: 60 cases with severe cerebrovascular disease were randomly divided into hypothermia group and control group. The anus temperatures of both groups were the same. In the hypothermia group the patients were cooled to 34～35 ℃; In the control group the patients were treated by routine methods. The Glasgow coma scores were measured before and 2 days, 5 days, 7 days after treatment, and the neurological function scores were measured before and 2 weeks, 4 weeks, 12 weeks after therapy in both groups. The mortality ratio and side effects in two groups were observed. Results: The scores of GCS and neurological function were found significantly different between mild hypothermia group and control group. The mortality ratios in hypothermia group and control group were 7.33% and 28.12% respectively(P<0.05). Conclusions: Mild hypothermia can provide neuroprotection for the patients with severe cerebrovascular disease and reduce the mortality ratio.