摘要
目的探讨亚低温治疗重度颅脑损伤的疗效和机制。方法60例重度颅脑损伤的患者分为亚低温治疗组32例,常温组28例,观察亚低温治疗前后颅内压(ICP)、脑灌注压(CPP)、脑电地形图(BEAM)、血清神经元特异性烯醇化酶(NSE)、经颅多普勒超声(TCD)的变化及预后。结果亚低温治疗组ICP、CPP、BEAM及预后与常温组比较,差异有显著性意义;亚低温治疗组血清NSE由治疗前的(125.3±21.4)ng/L降至伤后7d的(70.5±20.8)ng/L;TCD示大脑中动脉平均血流速度(Vm)由治疗前的(65.1±4.9)cm/s降至伤后7d的(52.7±4.3)cm/s(P<0.05),同时大脑中动脉收缩期血流速度(Vs)、搏动指数(PI)明显下降,其差异有显著性意义(P<0.05)。亚低温治疗组的生存质量明显高于对照组。结论亚低温治疗可明显改善重度颅脑损伤的临床症状、BEAM及预后,在降低ICP、升高CPP的同时,降低急性期血NSE,改善脑血流动力学变化。
Objective To analyze the effect and mechanism of hypothermia （HT） treatment for severe craniocerebral injury. Methods 32 cases were treated with moderate HT group and 28 cases with normal temperature （control group）, lntracranial pressure （ICP）, cranial perfusion pressure （CPP）, brain electrical activity map（BEAM）, serum NSE, transcranial ultrasonic Doppler （TCD） findings and prognosis （GCS） were observed both before and after moderate hypothermia treatment. Results In the treatment group, ICP, CCP, BEAM and outcome were improved after HT treatment with a significant difference compared with the control group. After hypothermia treatment, the average level of serum NSE in the treatment group was reduced from 125.3±21.4ng/L to 70.5±20.8 ng/L （p〈0.01）. Records of MCA mean velocity （Vm） were reduced from 65.1±4.9cm/s to 52.7±4.3 cm/s （P〈 0.01）. A decrease was seen in MCA systolic velocity （Vs） and pulse index （PI） value with a significant difference（P〈0.01）. Conclusions HT treatment can decrease ICP, increase CCP and improve the clinical manifestation, BEAM and outcome of severe craniocerebral injured patients improving the blood velocity of MCA and decreasing cerebral vascular resistance. HT treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia.
出处
《海南医学》
CAS
2007年第3期50-51,56,共3页
Hainan Medical Journal
关键词
脑损伤
脑电地形图
磷酸丙酮酸水合酶
经颅多普勒超声
亚低温
Brain injuries
Brain electrical activity map
Phosphopyruvate hydratase
Doppler, Ultrosound transcranial
Hypothermia
