早期局部亚低温治疗重型颅脑损伤患者的疗效观察

Efficacy of Early Local Mild Hypothermia Therapy in Patients with Severe Head Injury

目的评价早期局部亚低温治疗重型颅脑损伤(Severe traumatic brain inuyry,STBI)患者的疗效。方法整群选取2013年2月—2015年5月,收治的72例STBI,采用早期局部亚低温治疗31例纳入观察组,余者纳入对照组,均给予常规治疗;对比不同时间段L-selectin、脑温与GCS水平,对比死亡率、存活患者90日后ESS、BI与FMA水平。结果第7、14日观察与对照组L-selectin低于治疗前、GCS高于治疗前,第7、14日观察组脑温分别为(35.1±0.6)、(37.0±0.8)低于对照组(37.1±0.7)、(37.0±0.8)、观察组第7、14日GCS评分分别为(13.2±1.5)、(16.8±3.3)高于对照组(10.3±3.4)、(12.3±2.9),差异具有统计学意义(P<0.05);存活患者90日后,观察组BI(65±13)分、FMA(51±5)分分别高于对照组(55±13)分、(43±9)分,差异具有统计学意义(P<0.05),观察组ESS、死亡率与对照组差异无统计学意义(P>0.05)。结论早期局部亚低温治疗STBI疗效较好,可降低死亡率,减轻神经功能损伤,改善运动功能。

Objective To evaluate the early local mild hypothermia treatment of severe traumatic brain injury（Severe traumatic brain inuyry, STBI） patient outcomes. Methods Group selection february 2013 to May 2015, 72 patients were treated STBI, using early local mild hypothermia therapy study group included 31 cases, more than were included in the control group were given conventional treatment;compare the different time periods of L-selectin, brain temperature and GCS levels, and compare the mortality, survival of patients 90 days after ESS, BI and FMA levels. Results Seventh days, fourteenth days of observation and control group L-selectin was lower than that before treatment, GCS was significantly higher than that before treatment, seventh days and fourteenth days respectively, the observation group of brain temperature（35.1±0.6）,（37±0.8） is lower than that of the control group（37.1±0.7）,（37±0.8）, the observation group seventh, fourteenth, GCS scores were（13.2±1.5）,（16.8±3.3） higher than that of the control group（10.3±3.4）,（12.3±2.9）, the difference was statistically significant（P〈0.05）; patients surviving 90 days later, the observation group BI（65±13）, FMA（51±5） respectively higher than the control group（55±13）,（43±9）, the difference was statistically significant（P〈0.05）, the observation group ESS, mortality rate and the control group had no significant difference（P〉0.05）. Conclusion Early local mild hypothermia therapy STBI good effect, can reduce mortality, reduce neurological damage and improve motor function.