亚低温治疗重型颅脑损伤23例临床分析

目的　探讨亚低温在治疗重型颅脑损伤中的作用。方法　选择重型颅脑损伤病人 4 8例 ,随机分成治疗组 2 5例给予亚低温处理 ,即采用降温毯加冬眠肌松合剂 ,包括卡肌宁 2 0 0mg、氯西嗪 1 0 0mg加入盐水中持续输入 ,控制 2 0～ 4 0mL/h药量在 5～ 6h内使患者体温降至 32～ 34℃。另外 2 3例采用常规治疗。严格监护生命体征及血氧饱和度等指标。结果　 3个月后 ,对 2组病人进行GCS评分 ,判定疗效 ,亚低温组良好 1 7例 ,中重残 4例 ,死亡 2例 ;对照组良好 8例 ,中重残 6例 ,植物生存 3例 ,死亡 8例。结论　亚低温通过降低脑组织耗氧量、保护血脑屏障等机制 ,对重型颅脑损伤的治疗有重要临床意义。

Clinical Analysis on Severe Cerebral Injury Treated with Subhypothermia

Objective To discuss the action of sub-hypothermia in treatment of severe cerebral injury. Methods 48 cases of such patient were divided in to treatment group 25 cases. This group was taken the combination of hypothermia blanket with hibernation and muscular relaxant (tracium 200mg and chlorderazin 100mg infused 20～40mg/h and made patient at 32～34 Co within 5～6 hours). Other 23 cases were treated as routine therapy. Results The GeS score were assessed in both group after 3 months later. There were 17 cases curative effect, 4 cases moderate and severe disability, 2 cases died in treatment group. There were 8 cases curative effect, 6 cases moderate and severe disability, 3 cases vegetative survival and 8 cases died in control group. Conclusion Sub-hypothermia might have important significance in treating severe cerebral injury by the mechanism of decreasing oxygen consumption in brain and protecting blood-brain barrier.