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目的观察亚低温联合依达拉奉治疗重型颅脑创伤的临床效果。方法选取2013年1月—2015年1月苏州市高新区人民医院神经外科收治的重型颅脑创伤患者60例,采用随机数字表法将患者分为对照组和研究组,各30例。对照组患者给予颅内血肿清除术和/或去骨瓣减压术,研究组患者在对照组基础上给予亚低温联合依达拉奉治疗。比较两组患者临床效果〔美国国立卫生院神经功能缺损量表评分(NIHSS评分)、格拉斯哥昏迷量表评分(GCS评分)和日常生活能力评定指数(BI)〕、治疗前后大脑中动脉平均血流速度(Vm)、血清肿瘤坏死因子α(TNF-α)和白介素6(IL-6)水平。结果研究组患者治疗后NIHSS低于对照组,GCS和BI高于对照组(P<0.05)。两组患者治疗前Vm、血清TNF-α和IL-6水平比较,差异均无统计学意义(P>0.05);研究组患者治疗后Vm高于对照组,血清TNF-α和IL-6水平均低于对照组(P<0.05)。结论亚低温联合依达拉奉治疗重型颅脑创伤的效果确切,能有效改善术后Vm,减轻炎性反应。
Objective To observe the clinical effect of mild hypothermia combined with edaravone in the treatment of severe traumatic brain injury. Methods Sixty patients with severe craniocerebral trauma who were admitted to Department of Neurosurgery, People’s Hospital of Suzhou High-tech Zone from January 2013 to January 2015 were selected and randomly divided into control group and study group with 30 cases in each group. Patients in the control group were given intracranial hematoma and / or decompressive craniectomy. The study group was given mild hypothermia combined with edaravone on the basis of the control group. The clinical effects (National Institutes of Health neurological deficit scale score (NIHSS score), Glasgow coma scale score (GCS score) and daily living ability assessment index (BI)) were compared between the two groups. Mean blood flow in the middle cerebral artery Speed (Vm), serum tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) levels. Results The NIHSS in study group was lower than that in control group, GCS and BI were higher than those in control group (P <0.05). There were no significant differences in Vm, serum TNF-α and IL-6 levels between the two groups before treatment (P> 0.05). The Vm in study group was higher than that in control group, the levels of serum TNF-α and IL-6 Were lower than the control group (P <0.05). Conclusion Mild hypothermia combined with edaravone treatment of severe traumatic brain injury is effective, can effectively improve postoperative Vm, reduce inflammatory response.