重型颅脑损伤亚低温治疗46例临床观察

目的 研究亚低温治疗对重型颅脑损伤患者疗效及预后的影响.方法 回顾性分析46例重型颅脑损伤患者,随机分为亚低温治疗组（n＝23）及常温治疗组（n＝23）.亚低温组接受体温控制在32℃～35℃的亚低温治疗,常温治疗组除亚低温治疗外,其余治疗与亚低温组相同.比较两组患者的颅内压（intracranial pressure,ICP）、并发症及预后的差异.结果 亚低温治疗组伤后ICP显著低于常温治疗组（P＜0.01）.应激性溃疡、肝肾功能异常和外伤性癫痫的发生率显著低于常温治疗组（P＜0.01）;预后显著优于常温治疗组（P＜0.05）.结论 亚低温治疗能显著降低重型颅脑损伤患者的高颅压,减少并发症,改善预后和提高生活质量.

Clinical observation of 46 patients with severe traumatic brain injuryunder mild hypothermia therapy

Objective To study the impact of mild hypothermia therapy on curative effect and prognosis of patients with severe traumatic brain injuries. Methods Forty-six patients with severe traumatic brain injuries and randomly were retrospectively analyzed and divided into two groups with 23 patients in both group, mild hypothermia therapy group and normothermia therapy group. Patients in mild hypothermia group received hypothermia therapy with body temperature between 32 and 35 degrees centigrade; while patients in the other group received the same therapy as patients in mild hypothermia group did except for the low-temperature factor. The difference of intracranial pressure, complications and prognosis between two groups was compared. Results Patients having intracranial pressure in mild hypothermia group were fewer than patients in normothermia group （P 〈 0. 01 ）. Occurrence rate of stress ulcer, dysfunction of liver and kidney and traumatic epilepsy in mild hypothermia group was remarkably lower than another group （ P 〈 0. 01 ）. The prognosis in mild hypothermia group was remarkably better than normothermia group （P 〈 0. 05 ）. Conclusion Mild hypothermia therapy could remarkably help patients with severe traumatic brain injuries reduce intracranial pressure, decrease complications, improve prognosis and increase life quality.