低温联合依达拉奉治疗重型颅脑损伤临床观察

Clinical Observation of Mild Hypothermia Combined with Edaravone in Treatment of Patients with Severe Traumatic Brain Injury

目的观察低温联合依达拉奉治疗重型颅脑损伤的临床效果。方法选取重庆市黔江中心医院于2014年3月—2016年3月收治的重型颅脑损伤患者102例,根据治疗方法分为两组,每组51例。其中对照组采用常规治疗,联合治疗组在对照组基础上采用低温联合依达拉奉治疗。观察两组治疗前、治疗14 d后颅内压水平、格拉斯哥昏迷指数(GCS)评分,治疗3个月后采用格拉斯哥预后评分评价临床疗效。结果两组治疗前颅内压水平和GCS评分比较差异均无统计学意义(P>0.05)。治疗14 d后,两组颅内压均明显低于治疗前(P<0.01),且联合治疗组明显低于对照组(P<0.01)。治疗14 d后,两组GCS评分均明显高于治疗前(P<0.01),且联合治疗组明显高于对照组(P<0.05)。治疗3个月后,联合治疗组总有效率明显高于对照组(P<0.05)。结论低温联合依达拉奉治疗重型颅脑损伤可明显降低颅内压,提高临床效果。

Objective To observe clinical effect of mild hypothermia combined with Edaravone in treatment of patients with severe traumatic brain injury. Methods A total of 102 patients with severe craniocerebral injury admitted during March 2014 and March 2016 were divided into two groups （n = 51 for each group） according to different therapeutic methods. Control group received conventional therapy, while combination therapy group received mild hypothermia combined with Edaravone on the basis of treatment for control group. In two groups, intracranial pressure levels and Glasgow coma scale （GCS） scores were observed before and at 14thd after treatment, and clinical efficacy was evaluated in 3th month after treatment by Glasgow outcome scale evaluation. Results There were no significant differences in intracranial pressure levels and GCS scores before treatment in two groups （ P 〉 0.05 ）. After treatment for 14 days, intracranial pressure levels were significantly lower than those before treatment in two groups （P 〈 0.01 ） , and the level in combination therapy group was significantly lower than that in control group （ P 〈 0.01 ） ; the GCS scores were significantly higher than those before treatment in two groups （ P 〈 0.01 ）, and the score in combination therapy group was significantly higher than that in control group （P 〈 0.05）. After treatment for 3 months, the total effective rate in combination therapy group was significantly higher than that in control group （P 〈 0.05）. Conclusion Mild hypothermia combined with Edaravone can significantly reduce intracranial pressure and improve clinical efficacy in treatment of patients with severe traumatic brain injury.