亚低温结合镇静治疗对高血压脑出血术后脑血流影响的研究

Effect of mild hypothermia combined with sedation on cerebral blood flow velocity in postoperative Hypertensive intracerebral hemorrhage

目的:研究亚低温结合镇静治疗对高血压脑出血术后烦躁患者的临床疗效。方法:收集我科NICU2013年01月至2016年07月高血压脑出血术后烦躁患者50例,分为非亚低温+镇静组(空白组)25例,亚低温+镇静组(镇静组)25例。采用经颅多普勒超声(TCD)观察术前、术后6h、6.5h、7h、12h、18h、24h、48h、72h空白组与镇静组大脑中动脉平均血流流速(Vm)变化。结果:高血压脑出血术前、术后6h空白组、镇静组血流流速无差异(P>0.05)。术后6.5h、7h、12h、18h、24h、48h、72h空白组较镇静组血流流速快。术后3天内再出血率镇静组低于空白组(P<0.05)。结论:亚低温结合镇静治疗可改善高血压脑出血患者术后脑血流流速趋于正常,降低3天内再出血率。

Objective： To explore clinic effect of mild hypothermia combined with sedation on the dysphoric patients with hypertensive intracerebral hemorrhage after operation. Methods：Fifty dysphoric patients with operation of hypertensive intracerebral hemorrhage treated in our hospital from Jan 2013 through Jul 2016 were divided into two groups：twenty five cases were without mild hypothermia combined with sedation （the blank group）; Twenty five cases were mild hypothermia combined with sedation group （sedation group）. The average velocity of blood flow on middle cerebral artery of two groups were detected by transcranial doppler （TCD）at preoperative, postoperative 6h, 6.Sh,7h,12h,18h,24h,48h,72h.Results：There＇s no significant different between the average velocity of blood flow of preoperative, postoperative 6h（P〉0.05）. The average velocity of blood flow on middle cerebral artery of sedation group were lower than the blank group at postoperative 6.Sh,7h,12h,18h,24h,48h,72h （P〈0.05）. Secondary hemorrhage rate of sedation group were lower than the blank group at three days postoperation （P〈O.05）. Conclusions：Secondary hemorrhage rate in three days postoperation could be decreased and the average velocity of blood flow could be modulated to normal dates by mild hypothermia combined with sedation.