摘要
目的:探讨亚低温不同启动时间对成人缺血缺氧性脑病临床预后的影响及其机制。方法:所有患者分为A组(常规治疗)、B组(2h后亚低温治疗)、C组(2h内亚低温治疗);比较各组Glasgow评分及生活质量评分(ADL),各组患者临床预后,平均脑血流速度(Vm)、阻力指数(RI);搏动指数(PI)及动态脑电图分级。结果:C组较A、B组Glasgow评分提高,ADL评分降低,差异均有显著性(P<0.05);C组临床预后较A、B组好,总体有效率明显提高,差异均有显著性(P<0.05)。C组Vm较A、B组下降,PI、RI增高,差异均有显著性(P<0.05)。A组与B组之间各参数比较,差异均无显著性(P>0.05)。C组动态脑电图分级中预后良好率为30%,A、B组分别为26.2%、25.0%。结论:2h内启动亚低温治疗对改善成人HIE的临床预后有积极意义,其可能是通过降低脑能量及氧的消耗,拮抗脑血流痉挛,防止脑过度灌注发挥作用。
Objective To investigate the clinical prognosis for patients with AHIE by using different start time of sub-low temperature therapy. Methods All patients were classified into A group （common therapy）, B group （using low temperature therapy after two hour） and C group （using low temperature therapy within two hour）. And the Glasgow sc^re and ADL; clinical prognosis, Vm, PI, RI in different groups and AEEG level by EEG monitoring were compared respectively. Results There was significant difference about GLC score and ADL score, clinical effectiveness between C group and A, B group（P 〈 0.05）. Tile value of Vm was lower in C group than in A, B group, but the value of PI and RI were higher in C group than in A, B group, and the difference was significant among them （P 〈 0.05）. There was no difference about all parameters between A and B group. The effectiveness ratio about AEEG was 30% in C group,however,it was 26.2% and 25.0% in B and A group. Conclusion The sub-low temperature therapy used within 2 hour was effective in adult HIE, which might decrease energy and oxygen expenditure, resist cerebral vasospasm and increase blood supply for brain.
出处
《实用医学杂志》
CAS
北大核心
2012年第22期3748-3750,共3页
The Journal of Practical Medicine
基金
广东省自然科学基金项目(编号:10151018201000022)
关键词
缺血缺氧性脑病
亚低温治疗
临床预后
Hypoxic-ischemic encephalopathy
Sub-low temperature therapy
Clinical prognosis
