摘要
目的探讨亚低温冬眠疗法对重度脑挫伤病人的脑保护机理及临床疗效。方法46例重度脑挫伤患者(GCS≤8分)随机分为亚低温冬眠治疗组和常温治疗组。其中亚低温冬眠组22例,入院后4￣12h内行亚低温冬眠治疗,输液泵持续静脉点滴冬眠合剂,将肛温控制在32￣35℃,亚低温冬眠治疗4￣7d,同时检测颈动脉和颈静脉血气、电解质变化、血糖及生命体征等指标。常温组24例除未行亚低温冬眠治疗外,其余综合治疗及监测方法同亚低温冬眠组。两组病人均于伤后3个月根据GOS预后评分判定疗效。结果与常温组比较,亚低温冬眠治疗组脑氧耗明显降低,高血糖情况显著下降,生命体征及电解质等无明显差异,无严重并发症,死残率明显降低,预后显著改善。结论亚低温冬眠疗法具有显著的脑保护作用,临床应用于重度脑挫伤救治安全有效,无严重并发症。
Objective To study the clinical and protective effect of combined therapy of mild hypothermia and dormancy in the treatment of severe cerebral contusion and laceration. Methods Forty-six patients with severe cerebral contusion and laceration （GCS ≤ 8） were randomly divided into mild hypothermia and dormancy therapy group （22 cases） and the control group （24 cases）. The combined therapy of mild hypothermia and dormancy was applied within 4-12 hours after admission, the anal temperature at 32-35℃ and treatment course of 4-7 days. Meanwhile, blood gas analysis of carotid artery and cervical vein, blood electrolytes, blood sugar and vital signs were measured and observed. According to Glasgow Outcome Scale （GOS）, the prognosis of the patients was evaluated. Results In comparison with control group, during dormancy treatment and mild hypothermia, the brain oxygen consumption significantly decreased and hyperglycemia was alleviated to a obvious extent, but no significant changes was observed in respect of vital signs and blood electrolytes, even without severe complication. Mortality was reduced and good recovery rate was obtained in hypothermia group. Conclusion The combined therapy of mild hypothermia and dormancy are safe and effective for the prevention of brain injuries in patients with severe cerebral contusion and laceration, free from severe complication.
出处
《中华神经医学杂志》
CAS
CSCD
2006年第10期1040-1042,共3页
Chinese Journal of Neuromedicine
关键词
重度脑挫伤
冬眠疗法
亚低温疗法
血气分析
预后
Sever cerebral contusion and laceration
Dormancy treatment
Mild hypothermia
Blood gas analysis
Prognosis
