摘要
目的：探讨亚低温治疗对重型颅脑损伤患者颅内压（ICP）及脑血液生化学指标的影响。方法：回顾性收集81例重型颅脑损伤患者,根据治疗方法的不同分为观察组（n=48）和对照组（n=33）,所有患者入院后给予重型颅脑损伤常规治疗,在此基础上,观察组患者给予亚低温治疗,治疗时间为72h。动态监测所有患者入院时及治疗开始第1~7天ICP,入院时和治疗第7天脑血流指标动态阻力（DR）、脉搏波速（Wv）、脑部平均血流量（Qmean）、平均血流速度（Vmean）和脑氧代谢指标脑氧摄取率（CERO2）、颈内静脉血氧饱和度（SjvO2）、CjvO2、CaO2。结果：随着时间的延长,两组患者ICP呈逐渐下降的趋势,差异有统计学意义（F=17.982、6.324,P〈0.05）;第2天开始,观察组ICP显著低于对照组,持续至第7天,差异均有统计学意义（P均〈0.05）;与入院时比较,两组第7天DR、Wv、CaO2均显著降低,Qmean、Vmean、CjvO2、CERO2、SjvO2显著升高,差异有统计学意义（P〈0.05）;与对照组第7天比较,观察组DR、Wv、CaO2显著低于对照组,Qmean、Vmean、CjvO2、CERO2、SjvO2显著高于对照组,差异有统计学意义（P〈0.05）。结论：亚低温治疗可以显著降低重型颅脑损伤患者颅内压,改善脑血流和脑氧代谢,具有重要的临床意义。
Objective： To explore the influence of mild hypothermia therapy on on intracranial pressure and cerebral blood biochemical indexes of severe craniocerebral injury patients. Methods：A total of 81 cases with severe craniocerebral injury were divided into observation group （n= 48） and control group （n = 33） according to different treatment methods. All patients were given with conventional treatment, on this basis, patients in observation group were given with mild hypotbermia therapy for 72 h. ICP on admission and 1-7 d after treatment, cerebral blood flow indexes as DR, Wv, Qmean, Vmean and cerebral oxygen metabolism indexes as CERO2, SjvO2, CjvO2, CaO2 on admission and 7 d after treatment were detected. Results：ICP in two groups showed gradual decline trend with significant difference （F=17. 982, 6. 324, P〈0.05）. From the 2nd day, ICP in observation group was significantly lower than that in the control group （P〈0.05）. Compared with that on admission, DR, Wv, CaO2 in two groups were significantly decreased, Qmean, Vmean, CjvO2 , CERO2, SjvO2 were significantly increased on the 7th day （P〈0.05）. DR, Wv, CaO2 on the 7th day of observation group were significantly lower than that in the control group, Qmean, Vmean, CjvO2 ,CERO2 ,SjvO2 were significantly higher than that in the control group （P〈0.05）. Conclusion： Mild hypothermia therapy can significantly reduce ICP in patients with severe head injury, improve cerebral blood flow and cerebral oxygen metabolism, which has important clinical significance.
出处
《海南医学院学报》
CAS
2015年第7期933-935,938,共4页
Journal of Hainan Medical University
基金
四川省技术创新资助项目(2013EF00331)~~
关键词
亚低温
重型颅脑损伤
颅内压
脑血流
脑氧代谢
Mild hypothermia therapy
Severe head injury
Intracranial pressure
Cerebral blood flow
Cerebral oxygen metabolism
