亚低温治疗重型颅脑损伤的临床疗效及安全性评价

Clinical Efficacy and Safety Evaluation of Mild Hypothermia in Treatment of Severe Brain Injury

目的 分析研究亚低温治疗重型颅脑损伤的临床疗效及安全性。方法 选取2014年4月~2015年12月我院收治的126例重型颅脑损伤患者,随机分为两组,各63例。对照组给予降低颅内压、抗感染、维持水电解质平衡等常规治疗,观察组在此基础上联合亚低温治疗。对两组患者治疗前后颅内压、血清UCH-L1、GFAP进行测量,并统计两组治疗期间不良事件发生率及6个月后预后情况。结果 两组患者治疗前颅内压、血清UCH-L1、GFAP水平比较,差异无统计学意义（P〉0.05）,经治疗,观察组各项指标水平优于对照组,差异有统计学意义（P〈0.05）;对照组治疗期间未发生不良事件,观察组不良事件总发生率为3.17%,两组对比差异无统计学意义（P〉0.05）;观察组6个月后恢复良好率为46.03%,对照组恢复良好率为28.57%,组间比较差异有统计学意义（P〈0.05）。结论 采用亚低温治疗重型颅脑损伤,可有效降低患者颅内压、保护受损脑组织,具有一定安全性。

Objective To study the clinical efficacy and safety of mild hypothermia in treatment of severe brain injury. Methods 126 cases of severe craniocerebral injury patients admitted in our hospital from April 2014 to December 2015 were selected, they were randomly assigned to 63 patients in each group. The control group was treated with conventional therapy, such as reducing intracranial pressure, anti infection, maintaining water and electrolyte balance, and the observation group was treated with mild hypothermia. The intracranial pressure, serum UCH-L1 and GFAP were measured before and after treatment in two groups, and the incidence of adverse events and prognosis after 6 months in the two groups were statistically analyzed. Results There was no significant difference in the levels of intracranial pressure, serum UCH-L1 and GFAP between the two groups before treatment（P0.05）, after treatment, the level of the observation group was significantly better than that of the control group, the difference was statistically significant（P0.05）, there was no adverse event in the control group during the treatment, the incidence of adverse events in the observation group was 3.17%, there was no significant difference between the two groups（P0.05）, after 6 months, the recovery rate was 46.03% in the observation group and 28.57% in the control group, the difference was statistically significant（P0.05）. Conclusion Mild hypothermia in treatment of severe brain injury can effectively reduce the intracranial pressure and protect the brain tissue, which has a certain security.