《中国康复理论与实践》

《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (03): 181-182.

• 临床研究 • 上一篇    下一篇

联合应用亚低温和冬眠疗法治疗重度颅脑损伤

安沂华1; 刘恩重2; 俞春江3; 韩占强2   

  1. 1.北京市神经外科研究所 北京市 100050;2.哈尔滨医科大学第一临床医学院神经外科 黑龙江哈尔滨市 150001;3.哈尔滨医科大学第二临床医学院神经内科 黑龙江哈尔滨市 150086
  • 收稿日期:2003-12-12 出版日期:2004-03-25 发布日期:2004-03-25

Effect of combined therapy of mild hypothermia and hibernation on severe brain injury

AN Yi-hua,LIU En-zhong, YU Chun-jiang,et al   

  1. Beijing Neurosurgical Institute, Beijing 100050,China
  • Received:2003-12-12 Published:2004-03-25 Online:2004-03-25

PDF (PC)

被引次数

6

摘要： 目的观察联合应用亚低温和冬眠疗法治疗重度颅脑损伤的疗效。方法将24例重度颅脑损伤患者随机分为联合治疗组和常温对照组。所有患者的格拉斯哥昏迷指数均介于3-8分之间。在患者受伤10h之内,给予联合治疗组患者1号冬眠合剂全量,并使用冰毯将其体温降至32℃-34℃(直肠温度)。维持该组患者体温在这一范围内5d,随后上升至35℃维持24h,然后撤去冰毯,让体温自然上升至正常水平。在入院后第3d和第7d,检查颅内压、肌酸磷酸激酶、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血小板(Platelet,PLT)计数和血离子K+、Na+ 的浓度,计算其差值。入院7d后,记录患者的格拉斯哥结果指数及每组的死亡率。结果联合治疗组的死亡率 (25.0%)低于常温对照组(66.6%,P<0.05)。联合治疗组的颅内压、肌酸磷酸激酶和血小板计数分别显著低于常温组(P<0.05)。平均动脉压、血离子浓度、动脉血氧分压和二氧化碳分压方面在两组之间无显著差异(P>0.05)。结论联合应用亚低温和冬眠疗法能够有效地降低重度颅脑损伤患者的死亡率,而且具有简便易行、侵袭性小和并发症少等优点。

关键词: 低温, 脑损伤, 冬眠, 死亡率

Abstract: ObjectiveTo investigate the efficacy of combined therapy of mild hypothermia and hibernation to treat severe brain injury. Methods24 patients with severe brain injury were randomly divided into combined therapy group and normothermia group. Glasgow Coma Scale scores of all the patients were in the range of 3 to 8. No later than 10 hours after their injury, hypothermia patients were given half dosage of No.1 hibernation cocktail and had been cooled by cooling blankets to 32℃-34℃ (rectal temperature) for 5 days, then to 35℃ for 24 hours, and slowly increased to their normal level. 3 days and 7 days after their admission, intracranial pressure,creatine phosphate kinase,partial pressure of arterial O2 and CO2, platelet and Na+,K+ were measured.7 days after their admission, Glasgow Outcome Scale scores of each patient and mortality of each group were measured. ResultsThe mortality of combined therapy group(25.0%) was significantly lower than that of normothermia group (66.6%,P<0.05). The decreased values of intracranial pressure, creatine phosphate kinase and platelet number of combined therapy group were all significantly higher than that of normothermia group respectively (P<0.05). There were no significant difference in mean artery pressure, blood electrolyte, and partial pressure of arterial O2 and CO2 between these two groups(P>0.05). ConclusionThe combined therapy of mild hypothermia and hibernation can effectively reduce the mortality of patients with severe brain injury as it is much easier, less invasive and with less complications.

Key words: hypothermia, brain injuries, hibernation, mortality