局部亚低温治疗对蛛网膜下腔出血患者颅内血流动力学参数的影响

目的探讨局部亚低温治疗对蛛网膜下腔出血(SAH)患者颅内血流动力学参数的影响。方法 50例SAH患者随机分为亚低温治疗组(25例)和对照组(25例),对照组常规治疗,亚低温组同时应用局部亚低温治疗,分别在2、7、10、14 d经颅多普勒(TCD)检测2组患者大脑中动脉的平均血流速度(VMCA)及脉动指数(PI)。结果亚低温组出现脑血管痉挛(CVS)4例(16%),对照组出现脑血管痉挛9例(36%),差异有统计学意义(P<0.01);治疗第7、10、14天亚低温组VMCA均较对照组减小,差异有统计学意义(P<0.05,P<0.01);第10、14天2组间PI值比较,亚低温组较对照组减小,PI值均有明显差异(P<0.05,P<0.01)。结论亚低温治疗可减少蛛网膜下腔出血患者CVS发生率,缩短CVS持续时间。

Effect of local mild hypothermia treatment on hemodynamics parameter of the patients with subarachnoid hemorrhage

Objective To investigate the effect of local mild hypothermia treatment on hemodynamics parameter of the patients with subarachnoid hemorrhage(SAH).Methods Total 50 patients were randomly divided into control group and local mild hypothermia group,each group of 25 patients.The local mild hypothermia group patients were treated with local mild hypothermia treatment.The middle cerebral artery average blood flow rates(VMCAs) and pulse index(PIs) were detected by transcranial Doppler(TCD) on the 2nd,7th,10th,14th day.Results The 4(16%) cerebral vasospasm(CVS) patients were in the local mild hypothermia group,while 9(36%) CVS patients were in the control group.There was significant difference in the two groups(P<0.01).The VMCAs in the mild hypothermia group were significantly lower than the control group on the 7th,10th,14th day(P<0.05,P<0.01),and the PIs reduced on the 10th,14th day compared with the control group(P<0.05,P<0.01).Conclusion The mild hypothermia treatment could reduce the incidence rate and the persistence of CVS in the SAH patients.