亚低温治疗急性重型颅脑损伤病人的临床疗效

目的研究亚低温对急性重型颅脑损伤病人治疗作用及临床效果。方法共78例病人（GCS昏迷≤8分）随机分为亚低温治疗组和对照组。亚低温治疗组40例，均于伤后24h内行亚低温治疗。直肠温度控制在33～35℃，持续1～7d，平均（65．3±28．2）h。同时监测病人的生命体征、颅内压（ICP）、血气、血电解质及动脉血氧饱和度。对照组38例，直肠温度控制在36．5～37．5℃，其他治疗同亚低温组。两组病人均于伤后3个月时根据GOS评估法判定疗效。结果与对照组相比，亚低温治疗组病人伤后早期的高颅内压明显下降（P〈0．05）；生命体征、血气、血糖、血电解质、动脉血氧饱和度差异无显著性；无严重并发症，死亡率降低，恢复良好率提高，预后显著改善。结论亚低温具有肯定的脑保护作用，用于治疗急性重型颅脑损伤病人，可降低死亡率，提高生存质量，无严重并发症。

Clinical effect of mild hypothermia on patients with severe brain injury

Aim To study the effects of mild hypothermia on the patients with severe brain injury. Methods All 78 patients with severe injury （Glasgow coma scale of 8 or less on admission ） were randomly divided into the hypothermic group （40 eases） and the control group （ 38 eases ）. Hypothermia was induced within 24 hours of injury. Rewarming begun on 1 ～ 7 days （ average 65.3 ～ 28.2 hours ） after the rectal tamperature （RT） reached 33.0 ～ 35℃. Meantime, the vital signs intracranial pressure （ ICP）, blood gas values, blood electrolytes, blood oxygen pressure were measured. The rectal temperature of control patients was induced to 36.5 ～ 37.5 ℃. According to Glasgow Outcome Scale （GOS） ,the prognosis of the patients was evaluated. Results In comparison with control group, during mild hypothermia increased ICP significantly deereased（P 〈0. 05）. The vital sign,blood gas values and blood electrolytes did not significantly change. The decreased mortality and good recovery were also found in hypothermia group. Conclusion Mild hypothermia is safe and effective for preventing brain damage of the patients with severe head injury,which can reduce the mortality and improve the prognosis.