局部亚低温治疗脑出血患者改善神经功能缺损的近期疗效

Recent effect of local mild hypothermia for improving neurological deficits in patients with cerebral hemorrhage

目的:探讨局部亚低温治疗脑出血的临床疗效。方法:将42例脑出血患者按1∶1配对分为亚低温组(21例)和对照组(21例),对照组给以常规治疗,亚低温组在常规治疗的基础上应用局部亚低温治疗48h,监测患者鼓膜温度和生命体征,采用多田氏公式计算脑水肿量,采用欧洲卒中评分方法评价两组患者神经功能缺损程度。结果:治疗1周及2周后对照组脑水肿量分别为(21.52±5.52),(19.48±5.47)mL;而亚低温组脑水肿量分别为(17.14±4.57),(12.57±4.01)mL;二者比较差异有显著性意义(t=5.66,8.45,P<0.05)。治疗1周及2周后对照组欧洲卒中评分分别为(53.95±8.78),(62.43±7.95)分;亚低温组欧洲卒中评分分别(60.90±8.73),(71.38±7.21)分;两者比较差异有显著性意义(P<0.05)。结论:局部亚低温脑保护治疗结合常规治疗能减轻脑出血患者脑水肿量,减轻脑出血患者的神经功能缺损,提高临床疗效。

AIM:To investigate the clinical effect of local mild hypothermia in the treatment of cerebral hemorrhage. METHODS:Forty two patients with cerebral hemorrhage were divided into two groups (the mild hypothermia group and control group at a ratio of 1∶1. The mild hypothermia group included 21 cases treated with local mild hypothermia 48 hours after routine therapy.The control group had 21 cases only treated with routine therapy.Their temperatures of tympanic membrane,vital signs and neurological deficits(according to the European Stroke Scale) were observed respectively.The volume of cerebral edema was calculated according to the formula of Duotian. RESULTS:The volume of cerebral edema in the control group and mild hypothermia group was(21.52±5.52) and(17.14±4.57) mL 1 week after treatment,and(19.48±5.47) and(12.57±4.01) mL 2 weeks after treatment.There were significant differences in the volume of cerebral edema one and two weeks after treatment between the two groups(t=5.66,8.45,P< 0.05).The scores of European Stroke Scale were 53.95±8.78 and 60.90±8.73 for the two groups respectively one week after treatment and 62.43±7.95 and 71.38±7.21 for the two groups respectively two weeks after treatment.There was significant difference in the scores of European Stoke Scale one and two weeks after treatment between the mild hypothermia group and the control group(P< 0.05). CONCLUSION:Local mild hypothermia therapy with routine therapy can decrease the volume of cerebral edema and the neurological deficits in patients with cerebral hemorrhage so as to improve the clinical effects.