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目的探讨亚低温疗法在儿童重度颅脑损伤中的应用价值。方法选取2012年6月—2015年6月广安市人民医院收治的重度颅脑损伤患儿24例,根据随机数字表法分为观察组(n=13)和对照组(n=11)。对照组患儿给予常规治疗,观察组患儿在对照组基础上给予亚低温疗法。比较两组患儿不同时间点血清肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)、白介素4(IL-4)、白介素10(IL-10)水平和颅内压及预后。结果观察组患儿血清TNF-α、IL-1β水平低于对照组,且随治疗时间的延长而降低;血清IL-4、IL-10水平高于对照组,且随治疗时间的延长而升高(P<0.05)。观察组患儿颅内压低于对照组,且随治疗时间的延长而降低(P<0.05)。观察组患儿预后优于对照组(P<0.05)。结论亚低温疗法可能通过减弱炎性反应,提高炎性抑制因子水平,调节体内免疫平衡,降低颅内压而改善儿童重度颅脑损伤的预后,达到治疗目的。
Objective To investigate the value of mild hypothermia therapy in children with severe craniocerebral injury. Methods Twenty-four children with severe craniocerebral injury who were admitted to Guang’an People’s Hospital from June 2012 to June 2015 were divided into observation group (n = 13) and control group (n = 11) according to random number table. The control group of children given conventional treatment, the observation group of children in the control group on the basis of mild hypothermia therapy. The levels of TNF-α, IL-1β, IL-4, IL-10 and intracranial pressure and prognosis were compared between the two groups at different time points. Results The levels of serum TNF-α and IL-1β in the observation group were lower than those in the control group, and decreased with the prolongation of treatment time. The levels of serum IL-4 and IL-10 in the observation group were higher than those in the control group High (P <0.05). The intracranial pressure in observation group was lower than that in control group, and decreased with the prolongation of treatment time (P <0.05). The prognosis of observation group was better than that of control group (P <0.05). Conclusion Mild hypothermia may improve the prognosis of children with severe craniocerebral injury by decreasing the inflammatory response, increasing the level of inflammatory suppressor, regulating the immune balance in vivo and decreasing the intracranial pressure, so as to achieve the therapeutic goal.