全身亚低温治疗大面积脑梗死的疗效观察  

Observation of curative effect of whole-body mild hypothermia therapy on massive cerebral infarction

作　　者：李检生[1] 姜丹[1] 桂培根[2] 左奇[2] 彭军[1] 定正超[1] 阮争光[1] 吴银霞[1] 王晓萍[1] 张智燕[1] 雷蕾[1] 

机构地区：[1]武汉科技大学附属天佑医院神经内科,430064 [2]南华大学附属医院ICU

出　　处：《临床神经病学杂志》2009年第6期407-409,共3页Journal of Clinical Neurology

摘　　要：目的观察全身亚低温治疗大面积脑梗死的疗效。方法68例大面积脑梗死患者随机分为亚低温组(35例)和对照组(33例),两组在常规治疗的基础上,亚低温组应用亚低温疗法,包括用冰毯进行全身降温,冬非合剂(氯丙嗪50mg+异丙嗪50mg)+维库溴胺200～400mg+生理盐水至50ml、咪达唑仑50mg+生理盐水至50ml用微量泵注入,持续6～11d,维持肛温在32～33℃;根据治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及Barthel指数(BI)评价两组疗效,并统计死亡率和癫发生率。结果与治疗前比较,两组治疗后NIHSS评分显著降低,BI显著提高(均P<0.05),亚低温组治疗后NIHSS评分及BI改善明显优于对照组(均P<0.05);亚低温组的死亡率(9例,25.7%)明显低于对照组(19例,57.6%)(P<0.05);两组癫发生率差异无统计学意义。结论亚低温治疗大面积脑梗死疗效显著,可降低死亡率。Objective To observe the curative effect of whole-body miht hypothermia therapy on massive cerebral infarction（MCI）. Methods 68 MCI patients were divided randomly into the mild hypothermia group（35 cases） and control group（33 cases）. At the basic of routine treatment in the two guoups,the mild hypothermia group received whole-body mild hypothermia therapy, including the cooling blanket cave all the body for decrease temperature, Chlorpromazine （ 50 mg） plus Promethazine （ 50 mg） , Veeuroniumbromide （ 200 - 400 mg） , 0.9% sodium chloride to 50 ml; and Midazolam（50 mg） plus 0.9 % sodium chloride to 50 ml intravenous infusion slowly by trace-pump and continued 6 - 11 d. The rectal temperature was maintained between 32 -33℃. The curative effect was evaluated according to American National Institute of Health Stroke Scale（NIHSS） scores and Barthel index（BI） pre and post-treatment. The mortality and incidence of epilepsy in the two groups were statistical. Results Compared to pre-treatment,the scores of NIHSS were significantly reduced and BI were apparently increased in the both groups post-treatment（ all P 〈 0. 05）. Compared to control group, the improvement of NIHSS score and BI were remarkable better in mild hypothermia group（ all P 〈 0. 05 ）. The mortality in mild hypothermia group （9 cases,25.7% ） was significantly lower than that in control group（ 19 cases,57.6% ） （ P 〈 0. 05 ）. The incidence of epilepsy in the two groups was no significant difference. Conclusion The therapy of whole-body mild hypothermia for MCI patients has a good curative effect and can decrease the mortality.

关 键 词：全身哑低温 大面积脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]