亚低温疗法在重型颅脑损伤中的应用

Application of Mild Hypothermia Therapy in Severe Craniocerebral Injury

目的通过观察亚低温疗法对重型颅脑损伤患者术后凝血系统、应激氧化损伤和炎性因子水平的影响,分析亚低温疗法在重型颅脑损伤中的应用价值。方法将128例重型颅脑损伤患者按就诊顺序分为观察组与对照组,各64例。对照组按常规重型颅脑损伤救治,观察组在此基础行亚低温治疗,比较2组治疗前后格拉斯哥昏迷评分(GCS)、凝血功能[凝血酶还原时间(PT)、部分活化凝血活酶时间(APTT)、D-二聚体(D-dimer)]、应激氧化损伤[超氧化物歧化酶(SOD)水平、丙二醛(MDA)、脂质过氧化物(LPO)]及炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]等指标水平以及并发症发生率。结果观察组治疗总有效率71.88%,高于对照组的53.13%;治疗后2组凝血功能、氧化应激损伤及炎性因子等指标较治疗前均有改善,且观察组低于对照组,差异有统计学意义(P<0.05);2组肺炎、低血压发生率差异无统计学意义(P>0.05)。结论较常规重型颅脑损伤救治,联合亚低温疗法疗效更佳,对患者凝血功能、应激氧化损伤及炎性因子水平改善更好。

Objective To observe and analyse the hypothermia therapy on coagulation system,oxidative stress injury,inflammatory factor level of severe brain injury patients.Methods 128 cases of severe craniocerebral injury were randomly divided into observation group(n=64)and control group(n=64).Control group was given common treatment and observation group was given long term hypothermia therapy.The Glasgow Coma Scale(GCS),coagulation system,oxidative stress injury,inflammatory factor level changes of the two groups were compared.Results The improvement rate of the observation group was better than that of the control group,and total efficiency(71.88%)was higher than the control group(53.13%).Delayed traumatic hematoma,hyperfibrinolysis occurrence rate was lower than the control group,and hypotension occurrence rate was higher than the control group.The difference was statistic significant(P<0.05).The difference of pneumonia occurrence rate had no statistic significance(P>0.05).Conclusion Hypothermia therapy can avoid coagulation system,oxidative stress injury and the inflammatory factor level.