亚低温治疗弥漫性轴索损伤的临床疗效

Effectiveness of mild hypothermia on patients with diffuse axonal injury

目的 研究亚低温对弥漫性轴索损伤(Diffuse axonal injury,DAI)的治疗作用及临床效果。方法 53例DAI患者随机分为亚低温治疗组和对照组。亚低温治疗组26例,均于伤后24h内行亚低温治疗,直肠温度(RT)控制在32～33℃,持续1～7d,同时监测患者的生命体征、颅内压(ICP)、血糖、血气、电解质。对照组27例,其他治疗同亚低温组。两组患者均于伤后3个月根据GOS评估法判定疗效。结果 与对照组相比,亚低温治疗组患者伤后早期的高ICP显著下降(P<0.05);生命体征、血气及电解质差异无显著性意义(P>0.05);无严重并发症,病死率降低,恢复良好率提高,预后显著改善。结论 亚低温具有显著的脑保护作用,临床上用于治疗DAI患者,安全有效。

Objective To study the effectiveness of mild hypothermia on patients with diffuse axonal injury. Methods Patients with diffuse axonal injury were randomly divided into hypothermia group (26 cases) and control group (27 cases) . Hypothermia was induced within 24 hours of injury. Rewarming begun after 1-7 days when the rectal temperature(RT) reached 32 ~ 331. Meantime, the vital signs, intracranial pressure( ICP) , blood gas values and blood electrolytes were measured. According to Glasgow Outcome Scale( GOS), the prognosis of the patients was evaluated. Results In comparison with control group, the increased ICP decreased significantly in the hypothermia group ( P < 0.05) ;the vital signs,blood gas values and blood electrolytes did not change significantly; the mortality decreased, the recovery rate increased, and the prognosis of the patients improved. Conclusions Mild hypothermia is safe and effective for preventing brain damage of the patients with diffuse axonal injury, it can reduce the mortality and improve the prognosis.