亚低温治疗在急性重型颅脑损伤中的应用

发布时间：2018-01-02 09:18

本文关键词：亚低温治疗在急性重型颅脑损伤中的应用　出处：《新乡医学院学报》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨亚低温治疗在急性重型颅脑损伤中的应用效果。方法将2013年1月至2015年1月黄冈市中心医院收治的76例急性重型颅脑损伤患者分为观察组和对照组,每组38例。观察组患者于伤后24 h内行亚低温治疗,直肠温度控制在32.0~35.0℃;对照组患者采用降温毯将直肠温度控制在36.5~37.0℃;分别于治疗前及治疗后3个月检测患者颅内压(ICP)、空腹血糖(FBG)、血清乳酸水平、脑组织氧分压(Pbt O2)及脑微循环血流,于治疗后3个月进行疗效判定。结果观察组和对照组患者恢复良好率分别为34.21%(13/38)、13.16%(5/38),观察组患者恢复良好率显著高于对照组(P0.05)。治疗前2组患者ICP、Pbt O2、脑微循环血流、FBG和血清乳酸水平比较差异均无统计学意义(P0.05)。治疗后3个月2组患者ICP、FBG和血清乳酸水平显著低于治疗前(P0.05),Pbt O2、脑微循环血流显著高于治疗前(P0.05)。治疗后观察组患者ICP、FBG和血清乳酸水平显著低于对照组(P0.05),Pbt O2和脑微循环血流显著高于对照组(P0.05)。对照组和观察组患者的并发症发生率分别为55.26%(21/38)、39.47%(15/38),2组患者的并发症发生率比较差异无统计学意义(P0.05)。结论亚低温治疗急性重型颅脑损伤可显著改善患者ICP、Pbt O2和脑微循环血流,促进患者恢复。
[Abstract]:Objective to investigate the effect of mild hypothermia therapy on acute severe craniocerebral injury. Methods the patients were admitted to Huanggang Central Hospital from January 2013 to January 2015, 76 patients with acute craniocerebral injury were divided into observation group and control group, 38 cases in each group. To observe the injury within 24 h after mild hypothermia treatment group, the rectal temperature control at 32.0~35.0 DEG C; control group of patients with rectal temperature control in the cooling blanket will be 36.5~37.0 DEG C; respectively before and after treatment for 3 months were detected intracranial pressure (ICP), fasting blood glucose (FBG), serum lactate levels, brain tissue oxygen pressure (Pbt O2) and cerebral microcirculation in 3 months after treatment to determine efficacy results the observation group and the control group of patients with good recovery rate were 34.21% (13/38), 13.16% (5/38), the observation group of patients with good recovery rate was significantly higher than the control group (P0.05). 2 groups of patients before treatment of ICP, Pbt, O2, FBG and cerebral microcirculation. Serum lactate levels showed no significant difference (P0.05). 3 months after treatment in 2 groups of ICP, FBG and serum lactate level was significantly lower than before treatment (P0.05), Pbt O2, cerebral microcirculation blood flow was significantly higher than that before treatment (P0.05). After treatment, the patients in the observation group ICP, FBG and blood lactate level were significantly lower than the control group (P0.05), Pbt and O2 of cerebral microcirculation blood flow was significantly higher than the control group (P0.05). The control group and the observation group of patients with complication rate were 55.26% (21/38), 39.47% (15/38), 2 groups of patients with complications had no significant difference (P0.05). Injury can significantly improve patients conclusion ICP treatment of acute severe brain hypothermia, Pbt O2 and cerebral microcirculation, promote the recovery of patients.

【作者单位】：黄冈市中心医院神经外科;
【分类号】：R651.15
【正文快照】： 随着社会发展及高速交通工具的增多,颅脑损伤成为一种常见的、多发的、严重的创伤性疾病,根据颅脑解剖部位可分为头皮损伤、颅骨损伤和脑损伤,三者可合并存在[1]。急性重型颅脑损伤常见致伤原因为交通事故、高处坠落、失足跌倒等,致残率和病死率高,严重影响患者及其家庭的幸福

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