控制性过度通气治疗颅内出血的疗效观察

Clinical effects of controlling over-ventilation for treating intracranial hemorrage

目的 观察控制性过度通气治疗晚发性维生素K缺乏症所致颅内出血并有颅高压症的疗效。 方法 对 5 4例确诊为晚发性维生素K缺乏症所致颅内出血并有颅高压症的患儿 ,随机分为两组。过度通气组 2 8例 (治疗组 ) ,包括脑疝 12例 ,入院时即气管插管接呼吸机行控制性过度通气治疗。常规组 (对照组 ) 2 6例 ,包括脑疝 8例 ,按一般常规予以甘露醇等脱水剂治疗。结果 对照组 2 6例 ,死亡 13例 ,颅内出血无加重 ,治愈 13例 ,治疗组 2 8例 ,死亡 3例 ,颅内出血加重 0例 ,治愈 2 5例 ,抢救成功者昏迷评分 (Glasgow)≥ 8分的平均时间治疗组为 ( 15 3 2± 9 4)h ,对照组为 ( 3 1 6± 5 83 )h ,两组比较差异非常显著 (P <0 0 1)。结论 适当的控制性过度通气治疗晚发性维生素K缺乏症所致颅内出血、颅高压症可明显提高治愈率 。

Objective To investigate the effect of controlling over ventilation for treating intracranial hemorrage due to late vitamin K deficiency.Methods 54 cases with intracranial hemorrage due to late vitamin K deficiency were randomly divided into two groups.In over ventilation group 28 cases (treated group),including 12 cases cerebral hemia were taking tracheal cannulation and respirator at admission. In Control group 26 cases including 8 cases cerebral hernia were taking routine dehydration therapy with mannitol.Results 13 cases were death,6 cases got worse of intracranial hemorrage and 13 cases cured,in the control group 3 cases were death,and 25 cured cases in the treatment group.The mean time of the Glasgow score8 in success to rescue cases in the treatment group was (15 32±9 4)h,and that in the control group was (31 6±5\^83)h.It was significantly different between the two groups.Conclusion Proper controlling over ventilation for treating intracranial hemorrage due to late vitamin K deficiency and high intracranial pressure can obviously improve the prognosis, decrease the mortality rate and the mutilation rate.