急性重型颅脑创伤的亚低温治疗及预示疗效的相关因素  

Mild hypothermia on patients with acutely severe traumatic brain injury and preoperative factors predictive to prognosis

作　　者：邓其峻[1] 周立新[1] 骆秀梅[1] 梁泉[1] 梁学军[1] 崔连旭[1] 何睿瑜[1] 

机构地区：[1]广东省佛山市第一人民医院神经外科,528000

出　　处：《中华神经医学杂志》2005年第8期841-843,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨亚低温对急性重型颅脑创伤患者的治疗作用,并分析哪些临床指标可以预示良好疗效。方法对2000￣2004年我院246例接受亚低温治疗的急性重型颅脑创伤患者,伤后3个月进行格拉斯哥预后评分(G O S),并对伤后可影响预后的因素进行回顾性分析。结果死亡58例,植物生存状态19例,重残12例,中残17例,轻度或无功能障碍140例。可预示良好疗效的临床指标:伤后G C S评分≥5分、基础体温正常、非重度颅内高压、脑损害非弥漫性、治疗时间窗及时(≤6h)和时程足够(≥48h)。结论选择恰当的适应证、采取正确的亚低温治疗,对急性重型颅脑创伤患者可以获得较好效果。Objective To evaluate the therapeutical effect of mild hypothermia on patients with acutely severe traumatic brain injury and to analyse some clinical makers predicting a well outcome. Methods 246 patients who underwent mild hypothermia therapy between 2000 and 2004 was evaluated by GOS at 3 months aider injury, and a retrospective analysis was carried out to determine possible predictors of outcome. Results 58 patients died, 19 was persistent coma, and 12 was severe disable, 17 was moderate disable, 140 was light or no dysfunction. The following clinical markers contribute to prediction of satisfactory effect （P〈0.05）： GCS following injury ≥ 5, normal basal body temperature, nor severe intracranial pressure, nor diffuse brain injury, timely therapeutics time point （≤6 h）, and sufficient therapy duration （≥48 h）. Conclusion Mild hypothermia on patients with acutely severe brain injury results in satisfactory outcomes as long as the patients are chosen pertinently and the right method was used.

关 键 词：哑低温 颅脑损伤 预后 

分 类 号：R651.1[医药卫生—外科学]