物理降温联合小剂量双氯芬酸钠栓剂对重症颅脑损伤合并发热患者的保护作用及安全性评价

Protective effect and safety evaluation of physical cooling combined with low-dose diclofenac sodium suppository on patients with severe craniocerebral injury complicated with fever

目的评价物理降温联合小剂量双氯芬酸钠栓剂对重症颅脑损伤合并发热患者的保护作用及安全性。方法选取2016年10月至2019年12月贵航贵阳医院收治的113例重症颅脑损伤合并发热患者作为研究对象,按照随机数字表法分为观察组(n=56)与对照组(n=57)。观察组采用物理降温联合小剂量双氯芬酸钠栓剂治疗,对照组仅使用物理降温。比较两组降温疗效、起效时间、神经功能损伤程度、不良反应发生情况。结果观察组降温总有效率为98.21%,高于对照组的84.21%,退热起效时间为(2.25±1.79)h,显著短于对照组的(4.72±2.11)h,差异有统计学意义(P<0.05)。治疗前,两组美国国立卫生研究院卒中量表(NIHSS)评分比较差异无统计学意义;治疗后,两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论物理降温联合小剂量双氯芬酸钠对重症颅脑损伤合并发热患者的体温控制效果更佳,且未增加不良反应发生率,具有较高安全性,值得临床推广应用。

Objective To evaluate the protective effect and safety of physical cooling combined with low-dose diclofenac sodium suppository on patients with severe craniocerebral injury complicated with fever.Methods A total of 113 patients with severe craniocerebral injury complicated with fever admitted to Guihang Guiyang Hospital from October 2016 to December 2019 were selected as the research subjects,and they were di-vided into the observation group(n=56)and the control group(n=57)according to random number table method.The observation group was treat-ed with physical cooling combined with low-dose diclofenac sodium suppository,while the control group was treated with physical cooling only.The cooling effect,onset time,the degree of nerve function injury and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of cooling in the observation group was 98.21%,which was higher than 84.21%in the control group,and the on-set time of fever reduction was(2.25±1.79)h,which was significantly shorter than(4.72±2.11)h in the control group,and the differences were sta-tistically significant(P<0.05).Before treatment,there was no significant difference in National Institutes of Health stroke scale(NIHSS)score be-tween the two groups;after treatment,the NIHSS scores of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups.Conclusion Physical cooling combined with low-dose diclofenac sodium suppository has better temper-ature control effect on patients with severe craniocerebral injury complicated with fever,and does not increase the incidence of adverse reactions,which has high safety and is worthy of clinical promotion and application.