亚低温疗法在重型颅脑损伤治疗中的作用

目的探讨亚低温冬眠疗法对重型颅脑损伤患者的脑保护机制及临床疗效。方法将65例重型颅脑损伤患者(格拉斯哥昏迷评分≤8分)随机分为亚低温组(33例)和常温组(32例)。亚低温组入院后1~5 h内行亚低温冬眠治疗,输液泵持续静脉点滴冬眠合剂,肛温控制在32~35℃,亚低温冬眠治疗3~7 d,同时检测颈动脉和颈静脉血气、电解质、生命体征等指标。常温组除未行亚低温冬眠治疗外,其余治疗及监测方法同亚低温组。两组患者均于伤后根据格拉斯哥预后评分(GOS)判定疗效。结果亚低温组比常温组脑氧耗及死残率明显降低,预后明显改善。结论亚低温冬眠疗法具有显著的脑保护作用,临床应用于重型颅脑损伤救治安全有效,无严重并发症。

Application of mild hypothermia hibernation in the therapy of severe brain trauma

Objective To investigate the protection and clinical efficacy of mild hypothermia hibernation on severe brain trauma.Methods 65 patients with severe brain trauma(GCS≤8) were randomly divided into two groups.33 patients were treated with mild hypothermia within 1-5 hours,and cockstailytic continuous intravenous infusion by transfer pump for 3-7 days after injury,rectal temperature was maintained at 32~35℃.At the same time,blood gas of carotid and jugular vein,electrolyte and vital sign were monitored.In control group 32 cases were treated consisted with the mild hypothermia group except mild hypothermia.Curative effects of two groups were judged according to the GOS prognosis score at three months after brain trauma.Results The mild hypothermia group showed low oxygen consumption.Mild hypothermia therapy decreased mortality rate and improved prognosis.Conclusion Mild hypothermia therapy has an obvious protection in brain and can be applied to curing severe brain trauma without serious complication in clinic.