体温变化对大面积脑梗死的影响及干预对策  

The effect of temperature change on large cerebral infarction and countermeasure

作　　者：魏瑞丽[1] 叶应荣[2] 李新立[2] 刘群才[2] 杨燕[2] 

机构地区：[1]郑州大学第二附属医院神经内科,河南郑州450003 [2]解放军第159医院神经内科

出　　处：《中国基层医药》2004年第10期1165-1166,共2页Chinese Journal of Primary Medicine and Pharmacy

基　　金：济南军区"九五"计划课题 (0 2J13 7)

摘　　要：目的　观察高热患者对大面积脑梗死 (acreagecerebralinsarction ,LCI)的影响 ,探讨LCI患者高热的最佳降温方法。方法　 6 1例LCI患者 ,随机分为观察组 30例 ,颅脑降温治疗仪 (headtemperaturecontrolinstrument,HTI)组 31例。以观察组病死率、生存者预后神经功能缺损程度评分 (neurologicaldeficiencyscore,NDS)、日常生活能力评定 (activitydailyliving ,ADL) ;HTI组病死率、生存者预后NDS、ADL等为观察指标。结果　观察组病死率为 2 3 33% ,且高热持续时间越长病死率越高 (P <0 0 5 ) ,HTI组病死率为 3 2 3% ,与观察组比较病死率明显降低 (P <0 0 5 ) ;高热持续时间以≥ 4h预后最差 (P <0 0 5 ) ;体温以≥ 4 0℃预后较差(P <0 0 5 ) ;HTI组生存者预后NDS、ADL较观察组明显降低 (P <0 0 1)。结论　LCI患者 ,持续高热时间长或体温≥ 4 0℃生存者预后神经功能缺损明显增高 ,生活质量明显减低。Objective To observe the effect and discuss best hypothermia measure of hyperpyrexia to large acreage cerebral infarction(LCI).Methods 61 LCI patients were random divided into two groups with 30 cases in control group and 31 cases in treatment group using head temperature control instrument(HTI).The observed indicators were mortality rate,survival prognosis,neurological deficiency score(NDS) and daily living activity(ADL) in the two groups.Results Mortality rate in the control and treatment group was 23.33% and 3.23% respectively.The difference was significant(P<0.05).The duration of hyperpyrexia was positively related to morfality rate with the worset duration being over 4h and worst tempreture being over 40℃.THI group's survival prognosis NDS and ADL were obviously debased compared with the control group(P<0.01).Conclusion LCI patients' survival prognosis NDS was obviously heightened and ADL was obviously debased.Head hypothermia was the best measure for LCI in hyperpyrexia patients.

关 键 词：病死率 高热 患者 观察 预后 生存者 大面积脑梗死 结论 NDS ADL 

分 类 号：R743.33[医药卫生—神经病学与精神病学]