亚低温治疗对重型颅脑外伤合并外伤性蛛网膜下腔出血患者脑血管痉挛的影响

目的 探讨亚低温治疗（mild hypothermia,MHT）对合并外伤性蛛网膜下腔出血（t-SAH）的重型颅脑损伤患者脑血管痉挛（cerebral vasospasm,CVS）的影响.方法 将40例合并t-SAH的重型颅脑损伤患者随机分为对照组和亚低温组各20例,对照组予常规治疗,亚低温组在常规治疗的基础上加用亚低温治疗,在伤后第1、3、5、7、14天行予颅多普勒（TCD）动态检测大脑中动脉血流速度.结果 亚低温组大脑中动脉平均血流速度（VmMCA）较对照组有明显降低.CVS发生率明显低于对照组,差别有统计学意义（均P〈0.05）,持续时间也明显缩短.结论 MHT可以显著降低合并t-SAH的重型颅脑损伤患者的VmMCA,降低CVS发生率,缩短CVS持续时间,缓解CVS的强度,认为MHT治疗对防治CVS有显著作用.

Application of mild hypothermia for cerebral vasospasm after severe traumatic subarachnoid hemorrhage

Objective To investigate the effect of mild hypothermia （MHT） on the cerebral vasospasm （CVS） in patients with severe craniocerebral injury complicating subarachnoid hemorrhage （SAH）. Methods Forty patients with traumatic SAH were randomly divided into two groups： control group and MHT group. Patients in control group received routine treatment; pa- tients in MHT group received MHT in addition to routine treatment. The velocity of the middle cerebral artery （VmMCA） was moni- tored by transcranial Doppler （TCD） at the 1st, 3rd, 5th, 7th and 14th day. Results Compared to control group, the VmMCA in MHT group was significantly decreased （P〈0.05） and the incidence rate of CVS was reduced （P〈0.05）. Conclusion Mild hypothermia can significantly slow the speed of MCA blood flow and reduce the incidence rate of CVS in traumatic subarachnoid hemorrhage.