高原地区局部亚低温联合高压氧在治疗高血压脑出血中的应用  

Combination of local mild hypothermia and hyperbaric oxygen in treatment of hypertensive intracerebral hemorrhage at high altitude

作　　者：姚小军[1] 王晨[1] 原爱中[1] 程传斌 

机构地区：[1]解放军22医院内2科,青海格尔木816000

出　　处：《西南国防医药》2010年第2期144-146,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨高原地区局部亚低温(localmild hypothermia,LMH)联合高压氧(hyperbaric oxygen,HBO)治疗高血压脑出血(hypertensive intracerebral hemorrhage,HIH)的安全性及疗效。方法将我院119例HIH患者随机分为常规治疗组(对照组,55例)和LMH联合HBO组(治疗组,64例)。对照组给予脱水、降低颅内压、营养脑神经、控制血压、清除氧自由基等常规治疗;治疗组在给予常规治疗的同时,于入组后6h内给予头部亚低温治疗3～5d,入组第7d后开始给予高压氧治疗。观察颅内血肿体积、血糖、外周血白细胞(WBC),进行神经功能缺损评分;并随访12个月,根据远期生活质量评估(KPS)判定两组患者的疗效。结果与对照组相比,治疗组生活质量提高明显,KPS80分以上基本正常活动为50例(78.13%);对照组为26例(47.27%),两组比较差异有统计学意义。结论高原地区局部亚低温联合高压氧治疗能够降低HIH的病死率、致残率,减少并发症,改善预后。Objective To explore the safety and therapeutic effects of local mild hypothermia （LMH）combined with hyperbaric oxygen （ HBO ） on hypertensive intracerebral hemorrhage （ HIH ） at high altitude. Methods 119 cases of HIH in our hospital were randomly divided into conventional therapy group（ control group,55 cases）and LMH ＋ HBO group （treatment group,64 cases）. Patients in control group were given conventional treatment, such as dehydration, reduction of intracranial pressure, nutrition of cranial nerve, control of blood pressure, scavenging of oxygen free radicals and etc. Besides of above conventional treatment, those in treatment group were given brain mild hypothermia treatment within 6 h after enrollment for 3 - 5 d and hyperbaric oxygen therapy at 7 d after enrollment. Intracranial hematoma volume, blood glucose and peripheral white blood cell were observed, and neurological deficit score was recorded. Both groups were followed up for 12 months. According to long - term quality of life assessment（ KPS）, the therapeutic effects were evaluated in two groups. Results Compared with control group, quality of life in treatment group improved significantly and KPS of 50 cases （ 78. 13% ）was over 80 points which indicated an almost normal activity. While in the control group, only 26 cases （47.27%） reached over 80 points （ P 〈 0.05 ）. Conclusion Combination of LMH and HBO can reduce case fatality, disability, complications of HIH and improve its prognosis at high altitude.

关 键 词：高血压脑出血 高压氧 局部亚低温 高原 

分 类 号：R743.34[医药卫生—神经病学与精神病学]