不同时间局部亚低温治疗弥漫性轴索损伤的预后分析

目的探讨不同时间局部亚低温治疗对弥漫性轴索损伤的预后影响,为临床治疗的时间选择做出指导。方法选取该院自2010年9月—2013年9月用局部亚低温方法治疗的DAI患者140例,随机平均分为亚低温治疗组和常规治疗组,亚低温组分别给予不同时间的局部亚低温治疗。与常规治疗组进行比较,统计治疗结果并判定疗效。结果局部亚低温治疗弥漫性轴索损伤有效率（60%）明显优于常规治疗组（28.6%）,差异有统计学意义（P〈0.05）。局部亚低温治疗治疗效果与开始时间有明显相关性,治疗时间越早,预后恢复效果越明显。以12 h为分界值,入院12 h以内亚低温治疗的方法可以提高患者的预后,降低患者的伤残及死亡概率。12 h以后的治疗,预后则无明显效果。结论局部亚低温治疗对弥漫性轴索损伤的预后有效,治疗时间越早,预后恢复效果越明显。

Analysis of the Prognosis of Diffuse Axonal Injury Treated by Local Mild Hypothermia at Different Times

Objective To investigate the effect of local mild hypothermia at different times on the prognosis of diffuse axonal injury（DAI） so as to make guidance for the choice of clinical treatment time. Methods 140 patients with DAI treated by local mild hypothermia in our hospital from September 2010 to September 2013 were selected and divided into the mild hypothermia group and the conventional treatment group randomly and equally. The mild hypothermia group was given local mild hypothermia at different times, and compared with the conventional group, the therapeutic outcome was counted and the efficacy was evaluated. Results The effective rate of the mild hypothermia group treated by local mild hypothermia was 60%, significantly higher than 28.6% of the conventional treatment group, the difference was statistically significant（P〈0.05）. The treatment effect of local mild hypothermia was significantly correlated with the start time of the treatment, the earlier the treatment, the more obvious prognosis recovery effect would be. 12 hours were set as the cutoff value. Mild hypothermia treatment could improve the prognosis of the DAI patients hospitalized within 12 hours, reduce the disability and death probability, but it had no obvious effect on improving the prognosis of the DAI patients hospitalized over 12 hours. Conclusion Local mild hypothermia therapy is effective in improving the prognosis of diffuse axonal injury, the earlier the treatment, the more obvious prognosis recovery effect will be.