亚低温治疗在急危重症患者脑保护中应用.docVIP

亚低温治疗在急危重症患者脑保护中的应用 　　[摘要]目的 研究??低温脑保护在创伤性颅脑损伤治疗中的临床应用效果。方法 选择我院2013年1月～2016年1月收治入院的60例创伤性颅脑损伤患者作为研究对象，随机分为亚低温组和对照组，各30例。对照组仅给予开颅手术、抗炎、止血、脱水等基础治疗，亚低温组在对照组的基础上均于伤后24 h内行亚低温治疗，体温控制在33～35℃，持续～7 d，比较两组的总有效率，对治疗前后的脑水肿体积、血清SOD及MDA水平进行评价，记录两组治疗1年时的KPS评分及两组治疗过程中的副作用发生率。结果 亚低温组的总有效率为46.7%，高于对照组的23.3%，差异有统计学意义（P0.05）。两组治疗后的脑水肿体积、血清SOD及MDA水平明显低于治疗前，差异有统计学意义（P0.05）。结论 亚低温脑保护在创伤性颅脑损伤治疗中的临床应用效果确切，可减轻脑水肿，改善患者预后，值得推广。 　　[关键词]亚低温脑保护；创伤性颅脑损伤；脑保护；效果 　　[中图分类号] R454.5 [文献标识码] A [文章编号] 1674-4721（2017）09（c）-0021-04 　　[Abstract]Objective To study the clinical application effect of mild hypothermia in brain protection of patients with traumatic brain injury.Methods 60 patients with traumatic brain injury admitted to our hospital from January 2013 to January 2016 were selected as the subjects，and all patients were randomly divided into the mild hypothermia group and the control group，30 cases in each group.The patients in the control group were given only craniotomy，anti-inflammatory，hemostasis，dehydration and other basic treatment.In the mild hypothermia group，the hypothermia treatment was performed 24 hours after the injury，and the body temperature was controlled at 33-35℃ for 5-7 days on the basis of the control group.The total effective rate of the two groups was compared.Before and after treatment，the brain edema volume，serum SOD and MDA levels were evaluated.The KPS score and the side effects of the two groups were recorded.Results The total effective rate was 46.7% in the mild hypothermia group，which was higher than 23.3% in the control group，with significant difference （P0.05）.The brain edema volume，the levels of SOD and MDA in the brain tissue of the two groups after treatment was significantly lower than that before treatment，with significant difference （P0.05）.Conclusion The clinical application of mild hypothermia in the treatment of traumatic brain injury is effective，which can reduce brain edema and improve the prognosis of patients，it is worthy of promotion. 　　[Key word