亚低温治疗对重型颅脑损伤患者颅内压、脑血流及氧代谢的影响

Effect of Mild Hypothermia Treatment on Patients with Severe Traumatic Brain Injury

目的:探讨亚低温治疗对重症颅脑损伤(sTBI)患者颅内压(ICP)、脑血流及氧代谢的影响。方法:收集50例sTBI患者随机分为实验组和对照组,每组25例,均给予常规治疗,观察组在常规治疗基础上给予亚低温辅助治疗,检测患者治疗前、治疗第3、5、7天ICP动态变化以及治疗前和治疗7天后脑血流和氧代谢等指标变化。结果:治疗第3、5、7天ICP组间差异均具有统计学意义(P<0.05),随着治疗时间增加两组ICP均逐渐降低,差异具有统计学意义(P<0.05);治疗前Qmean、Vmean、Wv、DR等组间差异无统计学意义(P>0.05),治疗7天后Qmean、Vmean均升高,Wv、DR均降低,差异具有统计学意义(P<0.05);治疗前SjvO_2、CjvO_2、CaO_2、CERO_2组间差异无统计学意义(P>0.05),治疗7天后SjvO_2、CjvO_2、CERO_2均升高,CaO_2降低,差异具有统计学意义(P<0.05)。结论:亚低温治疗可以显著降低患者颅内压,改善脑血流和氧代谢水平。

Objective： To investigate the effect of mild hypothermia treatment on intracranial pressure（ICP）, cerebral blood flow and oxygen metabolism in patients with severe traumatic brain injury（s TBI）. Methods： A total of 50 patients with s TBI were collected and randomly divided into experimental group（n=25） and control group（n=25）. All the patients were given routine treatment,on the basis of which the observation group was treated with mild hypothermia. The ICP dynamic changes before treatment and the 3th, 5th, 7th day after treatment and changes in cerebral blood flow and oxygen metabolism and other indexes before treatment and 7 days after treatment of the two groups were detected. Results： The differences of ICP between the two groups were statistically significant the 3th, 5th, 7th days after treatment（P〈0.05）; the ICP of two groups gradually decreased along with the increase of the treatment time, the differences were statistically significant（P〈0.05）. The Qmean and Vmean were increased and the DR and Wv were decreased 7 days after treatment,the differences between the two groups were statistically significant（P〈0.05）. The SjvO_2 CjvO_2and CERO_2 were all increased, and CaO_2 decreased 7 days after treatment, the differences between the two groups were statistically significant（P〈0.05）. Conclusion： Mild hypothermia treatment can significantly reduce intracranial pressure and improve the levels of cerebral blood flow and oxygen metabolism of the patients with s TBI.