长时程亚低温治疗动脉瘤性蛛网膜下腔出血效果

Effect of long-term mild hypothermia in the treatment of aneurysmal subarachnoid hemorrhage

目的探究长时程亚低温治疗对高分级动脉瘤性蛛网膜下腔出血(aSAH)患者疗效及预后的影响。方法选取2015年3月—2018年1月在高唐县人民医院南院区进行高分级aSAH治疗的80例患者,随机分为常规组和亚低温组各40例,常规组患者行常规手术治疗,亚低温组患者在常规手术治疗基础上开展长时程亚低温治疗,比较两组患者治疗各时段颅内动脉血流平均流速(VmMCA)、脑血管痉挛(CVS)发生概率、治疗效果及预后情况。结果两组患者治疗前VmMCA水平差异无统计学意义(P>0.05)。治疗各时段,亚低温组患者VmMCA水平均明显低于常规组;亚低温组患者CVS发生率为12.50%,明显低于常规组的32.50%;亚低温组患者治疗总有效率为80.00%,明显高于常规组的62.50%;亚低温组患者预后良好率明显高于常规组,且死亡率明显低于常规组,差异均有统计学意义(P<0.05)。结论在高分级a SAH患者治疗期间实施长时程亚低温治疗,对提高患者治疗效果具有重要意义并能够在一定程度上避免CVS的发生,有助于改善患者预后情况,值得临床推广应用。

Objective To investigate the effect of long-term mild hypothermia on the efficacy and prognosis of patients with high grade aneurysmal subarachnoid hemorrhage(aSAH).Methods From March 2015 to January 2018,80 patients with high grade aSAH in South Campus,Gaotang County People’s Hospital were selected and randomly divided into conventional group and mild hypothermia group,with 40 cases in each group.Patients in the conventional group were treated with conventional surgery,while patients in the mild hypothermia group were treated with long-term mild hypothermia on the basis of conventional surgery.The occurrence probability of mean intracranial arterial blood flow velocity(VmMCA)and cerebral vasospasm(CVS),treatment effect and prognosis were compared between the two groups.Results There was no significant difference in VmMCA levels before treatment between the two groups of patients(P>0.05).During each period of treatment,the levels of VmMCA in the mild hypothermia group were significantly lower than those in the conventional group;the incidence of CVS in the mild hypothermia group was12.50%,which was significantly lower than 32.50%in the conventional group;and the total effective rate in the mild hypothermia group was 80.00%,which was significantly higher than 62.50%in the conventional group;the excellent rate of prognosis of the mild hypothermia group was significantly higher than that in the conventional group,and the mortality was significantly lower than that in the conventional group,and the differences above all were statistically significant(P<0.05).Conclusion During the treatment of patients with high grade aSAH,long-term mild hypothermia treatment was of great significance to improve the therapeutic effect of patients,and could avoid the occurrence of CVS to a certain extent,which was helpful to improve the prognosis of patients,and was worthy of clinical application and popularizing.