亚低温冬眠治疗重型颅脑损伤的疗效观察及护理体会

目的探讨亚低温冬眠治疗重型颅脑损伤的临床效果。方法将收治的48例重型颅脑损伤患者随机分为治疗组和对照组,每组24例。治疗组均于伤后24 h内采用亚低温冬眠治疗,即持续静滴冬眠1号(10%GS 500 ml,氯丙嗪50 mg,异丙嗪50 mg,哌替啶100 mg),并配合全身物理降温及常规应用脱水、激素、止血、抗感染及预防上消化道出血等药物治疗。对照组除不应用亚低温冬眠疗法以外,其他疗法同治疗组。结果两组于治疗后第1、3、7天的血糖和颅内压、住院4周内的平均昏迷时间、存活率、死亡率、并发症发生情况;半年后对存活者随诊的治愈、中残、重残、植物存活比较,皆有显著性差异(P<0.05)。结论亚低温冬眠治疗及针对性的护理具有肯定的脑保护作用,能迅速改善患者临床症状,是安全有效的重型颅脑损伤的治疗方法,使患者的生存率、治愈率明显提高,病死率和致残率明显降低。

THE TREATMENT AND NURSING OF PATIENTS WITH SEVERE CRANIOCEREBRAL INJURY WITH SUB-HYPOTHERMIA HIBERNATION

Objective To explore the clinical effects of sub-hypothermia hibernation therapy in treating se-vere craniocerebral injury.Methods48 cases were randomly divided into the treatment group and the contrast group.The 24 cases in the treatment group were treated with sub-hypothermia hibernation within 24 hours by intravenous injection of 500ml of 10%GS,50mg of chlorpromazine,50mg of promethazine and 100mg of me-peridine as well as the routine treatments.The 24 cases in the contrast group were treated with routine meth-ods.ResultsThere existed significant differences between the two groups in terms of the content of blood glucose and the intracranial pressure on the 1st,3rd and 7th days after treatments,the average coma time during the 4 weeks of hospitalization,the survival rates,the death rates,and the occurrences of complications.The follow-up surveys showed that there also existed significant differences in the curative effects,the degree of disablement and the vegetative survival rate a half year later(P<0.05).ConclusionSub-hypothermia hibernation and ap-propriate nursing can produce high curative effects in severe craniocerebral injury.