论文部分内容阅读
目的探讨冬眠低温对重型颅脑外伤患者脑氧代谢及预后的影响。方法对符合要求的46例重型颅脑损伤患者进行生命体征监测和格拉斯哥昏迷评分(GCS),随机分成两组:冬眠低温组和常温组。监测颅内压(ICP)、股动脉血气和颈内静脉血气,根据结果计算颈内静脉氧饱和度(SjvO2)、脑氧摄取(CEO2)和动静脉氧含量差(AVDO2)。结果低温组伤后1d开始SjvO2升高,CEO2和AVDO2降低,与常温组相比差异均有显著性(P<0.01)。低温组ICP较常温组升高幅度小,相比有显著性差异(P<0.01)。两组患者死亡率对比,差异明显(P<0.01)。结论重型脑损伤后立即给与冬眠低温治疗,可以明显降低脑组织耗氧量,增加脑组织对缺氧缺血的耐受力,减轻脑水肿,降低颅内压,改善预后。
Objective To investigate the effect of hypothermic hibernation on cerebral oxygen metabolism and prognosis in patients with severe traumatic brain injury. Methods Forty-six patients with severe traumatic brain injury were monitored for vital signs and Glasgow Coma Scale (GCS), and were randomly divided into two groups: hibernation hypothermia group and normothermic group. Intracranial pressure (ICP), femoral arterial blood gas and jugular venous blood gas were monitored. SjvO2, CEO2 and AVDO2 were calculated according to the results. Results SjvO2 increased, while CEO2 and AVDO2 decreased at 1 day after injury in the hypothermia group, which were significantly different from those in the normal temperature group (P <0.01). Compared with the normal temperature group, the increase of ICP in the low temperature group was smaller than that in the normal temperature group (P <0.01). The mortality of the two groups was significantly different (P <0.01). Conclusion Severe hypobaric hypothermia was given immediately after severe brain injury, which could significantly reduce brain oxygen consumption, increase brain tolerance to hypoxia-ischemia, reduce brain edema, decrease intracranial pressure and improve prognosis.