术中超早期亚低温治疗对重症自发性脑出血的临床疗效

Clinical efficacy of intraoperative ultra-early mild hypothermia treatment for severe spontaneous intracerebral hemorrhage

目的评估术中超早期亚低温治疗对重症自发性脑出血的临床疗效。方法纳入2021年1月至2023年6月该院神经外科收治的重症自发性脑出血患者71例,其中术中超早期亚低温治疗组35例(研究组)、术后亚低温治疗组36例(对照组),分别于术后即刻、6 h、24 h、72 h和7 d采集患者静脉血标本测定C反应蛋白(CRP)及白细胞介素-6(IL-6)水平,并于术后3个月行美国国立卫生研究院卒中量表(NIHSS)评分及格拉斯哥预后(GOS)评分,分析两组患者CRP、IL-6水平、NIHSS评分及预后良好率的差异。结果两组患者术后即刻血CRP及IL-6水平差异无统计学意义(P>0.05);术后6 h、24 h、72 h和7 d,研究组患者的血CRP及血IL-6水平均较对照组低,差异有统计学意义(P<0.05);术后3个月,研究组患者NIHSS评分较对照组低,预后良好率较对照组高,差异均有统计学意义(P<0.05)。结论术中超早期亚低温治疗对重症自发性脑出血患者比术后亚低温治疗有更好的临床疗效。

Objective To evaluate the clinical effect of intraoperative ultra-early mild hypothermia on severe spontaneous intracerebral hemorrhage.Methods A total of 71 cases of severe spontaneous intracerebral hemorrhage admitted and treated in the neurosurgery department of this hospital from January 2021 to June 2023 were included,in which 35 cases were in the intraoperative ultra-early mild hypothermia treatment group(the study group),36 cases were in the postoperative mild hypothermia treatment group(the control group).The venous blood samples were collected immediately after operation end,at 6,24,72 h and on 7 d after operation for detecting the C-reactive protein(CRP)and interleukin-6(IL-6)levels.The national institutes of health stroke scale(NIHSS)scoring and the Glasgow Outcome Scale(GOS)scoring in the two groups were conducted in postoperative 3 months.The independent sample t test was used to analyze the differences in CRP,IL-6 and NIHSS score between the two groups and the chi square test was adopted to analyze the good prognosis rate of the two groups.Results There was no statistically significant difference in serum CRP and IL-6 levels immediately after operation between the two groups(P>0.05),but the serum CRP and IL-6 levels at 6,24,72 h,7 d after operation in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The NIHSS in postoperative 3 months in the study group was lower that that in the control group,while the prognosis good rate in postoperative 3 months was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion The intraoperative ultra-early mild hypothermia treatment for severe spontaneous intracerebral hemorrhage has better clinical effect than postoperative mild hypothermia.