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目的探讨亚低温治疗弥漫性轴索损伤的疗效。方法以2007-10—2013-01惠州市中心人民医院及惠州市第一人民医院确诊的102例DAI患者为研究对象,根据双盲原则随机分为常温组和亚低温组,同时选择在惠州市中心人民医院及惠州市第一人民医院参加健康体检的30例健康志愿者作为正常对照组。比较患者治疗前后的GCS评分、FA差值,以及治疗后mRS评分,并用多元线性回归方法分析影响预后的因素。结果治疗后,常温组和亚低温组GCS值都有明显升高(P<0.05)。相比于常温组、亚低温组患者,治疗后GCS评分升高更明显(P<0.05)。相比于健康对照组,常温组和亚低温组患者治疗前后胼胝体的膝部、体部和压部的FA差值都有明显差异(P<0.05)。同时,相比于常温组、亚低温组患者治疗前后胼胝体的膝部、体部和压部的FA差值也有明显差异(P<0.05)。多元线性回归结果表明,影响预后指标mRS评分的因素有年龄、吸烟、初始GCS评分以及治疗方式。相比于常温治疗,亚低温治疗能有效提高患者的预后情况。结论亚低温治疗能有效治疗弥漫性轴索损伤,改善弥漫性轴索损伤患者的预后,值得在临床应用中加以推广
Objective To investigate the effect of mild hypothermia on diffuse axonal injury. Methods A total of 102 patients with DAI confirmed by Huizhou Central People ’s Hospital and Huizhou First People’ s Hospital from October 2007 to October 2013 were randomly divided into normal temperature group and mild hypothermia group according to the double - blind principle. At the same time, Central People’s Hospital and Huizhou First People’s Hospital to participate in the health examination of 30 healthy volunteers as a normal control group. GCS score, FA difference before and after treatment, and post-treatment mRS score were compared, and multivariate linear regression analysis was used to analyze the prognostic factors. Results After treatment, the GCS values were significantly higher in the normal temperature group and the mild hypothermia group (P <0.05). Compared with the normal temperature group, mild hypothermia patients, GCS score increased significantly after treatment (P <0.05). Compared with healthy control group, FA differences of knee, body and pressure of corpus callosum in normal temperature group and mild hypothermia group were significantly different before and after treatment (P <0.05). At the same time, FA differences of knee, body and pressure of corpus callosum before and after treatment in mild hypothermia group were also significantly different from those in normal temperature group (P <0.05). Multivariate linear regression analysis showed that the factors influencing the prognostic mRS score were age, smoking, initial GCS score, and treatment modalities. Compared to normal temperature treatment, mild hypothermia can effectively improve the prognosis of patients. Conclusion Mild hypothermia can effectively treat diffuse axonal injury and improve the prognosis of patients with diffuse axonal injury, which is worth to be promoted in clinical application