血管腔内降温新技术在重症颅脑外伤合并高热患者中的初步应用

目的 探讨血管内降温技术在重症颅脑损伤合并高热患者中的应用价值.方法选择4例重症颅脑损伤患者,其GCS评分为4～8分,伤后应用CoolGard体温控制系统以及Icy导管（全部导管均为美国ALSIUS公司提供）即：血管内降温技术.控制膀胱温度在35 ℃～36 ℃之间,持续3～7 d,同时监测患者生命体征、凝血功能、血常规、血气及血电解质.结果降温期间,患者体温能快速达到并维持在目标温度,临床评估无一例发生由血管内降温带来的并发症.4例患者中一例死亡,3例经积极救治意识状况转为清醒,神经系统功能恢复良好.结论应用血管腔内降温新技术能迅速且平稳地将患者体温降到目标温度,无不良反应发生.对实施亚低温脑保护并进而改善患者预后起到积极作用.

The preliminary application of endovascular cooling technique in severe cranial cerebral trauma patients with hyperpyrexia

Objective To investigate the value of endovascular cooling technique in severe cranial cerebral trauma patients with hyperpyrexia. Methods Four patients with severe cranial cerebral trauma（ GCS range from 4 to 8 ） were selected to receive CoolGard endovascular cooling system to control the patients＇ bladder temperature between 35 ℃ - 36 ℃. This process lasted for 3 to 7 days. Vital signs, blood coagulation function, blood routine test, blood analysis and blood electrolytes were monitored during the process. Results Target temperature can be quickly achieved and steadily maintained, and no cooling associated complications were observed. Three of the four patients＇ consciousness recovered to alert with good function of nervous system. Conclusion The endovascular cooling technique can be quickly and effectively applied to decrease the patients＇body temperature to target temperature,with no associated complications. It plays a positive role in applying mild hypothermia so as to improve the prognosis.