亚低温治疗对重症高血压脑出血患者术后颅内压的影响

Influence of mild hypothermia therapy on postoperative intracranial pressure of severe hypertensive cerebral hemorrhage patients

目的研究亚低温治疗对重症高血压脑出血患者术后颅内压的影响。方法选择2013年3月至2015年3月在我院接受治疗的重症高血压脑出血患者120例,将患者随机分为研究组(70例)和对照组(50例),两组均进行常规的血压控制,降低颅内压和防治并发症的治疗,观察组患者在此基础上采用亚低温治疗。其中观察组70例,对照组50例,比较患者在术后1、12、24、72h以及1周的颅内压情况。并对患者术后1h、1d、3d、5d、1周的近期临床疗效与术后6个月的远期生存质量进比较分析。结果两组患者在术后不同时间点患者颅内压的变化情况:观察组患者在术后72h的颅内压(23.83±4.67)mmHg,显著高于对照组患者的颅内压(28.82±4.84)mmHg,差异有统计学意义(P<0.05);两组患者的近期临床疗效评分与远期生活质量比较:观察组患者的近期不同时间段的临床疗效评分低于对照组(P<0.05);观察组远期生存质量良好所占百分比为90.67%,显著高于对照组所占百分比57.33%,差异有统计学意义(P<0.05);两组患者死亡和植物生存人数相比,差异没有统计学意义(P>0.05),重残、中残、良好差异有统计学意义(P<0.05)。结论亚低温治疗重症高血压脑出血效果显著,能有效降低颅内压,改善患者脑功能,可在临床推广应用。

Objective To study the influence of mild hypothermia therapy on postoperative intracranial pressure of severe hypertensive cerebral hemorrhage patients. Methods 120 patients with severe hypertensive cerebral hemorrhage were divided into the observation group （70 cases） and the control group （50 cases）. Both groups were treated with con- trol of regular blood pressure, reduce of intracranial pressure and prevention of complications. The observation group was treated with mild hypothermia therapy, additionally. The intracranial pressure 1 h, 12 h, 24 h, 72 h, and 1 week after operation were observed. The clinical curative effect 1 h, 1 d, 3 d, 5 d and 1 week after operation and long-term survival of quality were analyzed, Results Two groups of different time points after surgery in patients with changes of the pa- tients with.. The intracranial pressure 72 h after surgery of observation group （23.83 ± 4.67） mmHg was significantly higher than that of control group （28.82±4. 84） mmHg （P〈0.05）. The clinical curative effect score at different time of observation group were lower than that of control group. The well survival quality rate of observation group （90.67 %） was higher than that of the control group （57.33%） （P〈0.05）. The died and plant man of the two group were not sta- tistically different between the two groups（P〈0.05）. The degrees of disability of the two groups had statistically differ- ence （P〈0.05）. Conclusion Hypothermia therapy for severe hypertensive cerebral hemorrhage can effectively reduce intracranial pressure of the patients and improve the brain function.