冬眠低温疗法对重型颅脑外伤患者脑氧代谢及预后的影响  

Influence of Mild Hypothermia on Cerebral Oxygen Metabolism and Prognosis of Patients with Severe Head Injury

作　　者：隋廷林[1] 张东明[1] 

机构地区：[1]胜利油田胜利医院神经外科,山东东营市257055

出　　处：《医药论坛杂志》2010年第1期4-6,共3页Journal of Medical Forum

摘　　要：目的探讨冬眠低温对重型颅脑外伤患者脑氧代谢及预后的影响。方法对符合要求的46例重型颅脑损伤患者进行生命体征监测和格拉斯哥昏迷评分(GCS),随机分成两组:冬眠低温组和常温组。监测颅内压(ICP)、股动脉血气和颈内静脉血气,根据结果计算颈内静脉氧饱和度(SjvO2)、脑氧摄取(CEO2)和动静脉氧含量差(AVDO2)。结果低温组伤后1d开始SjvO2升高,CEO2和AVDO2降低,与常温组相比差异均有显著性(P<0.01)。低温组ICP较常温组升高幅度小,相比有显著性差异(P<0.01)。两组患者死亡率对比,差异明显(P<0.01)。结论重型脑损伤后立即给与冬眠低温治疗,可以明显降低脑组织耗氧量,增加脑组织对缺氧缺血的耐受力,减轻脑水肿,降低颅内压,改善预后。Objective To study the effect of mild hypothermia on cerebral oxygen metabolism and patients prognostic.Methods Fifty-three patients after surgery for serious head injury were studied and randomly divided into hypothermic groups and normal temperature groups.ICP,burst artery blood gas analysis,jugular bulb for gas analysis,jugular bulb blood oxygen saturation（SjvO2）,cerebral arterial-venous oxygen content difference（AVDO2） were accessed and scored,and cerebral extraction of oxygen（CEO2） were calculated in all the patients.Results From the first post injury day SjvO2 increased and CEO2 and AVDO2 decreased in hypothermic groups.There were significant differences between hypothermic groups and normal temperature groups（all P〈0.01）.ICP of hypothermic group is lower than that of normal temperature group（P〈0.01）.There were significant difference in death rate between hypothermic group and normal temperature group（P〈0.01）.Conclusion In the earlier period of patients with serious head injury,mild hypothermia could significantly decrease cerebral oxygen metabolism,increase the tolerance to cerebral ischemia,alleviate cephaledema,descend intracranial hypertension and improve patients prognosis.

关 键 词：冬眠低温 脑损伤 重型 氧代谢 脑 颅内压 

分 类 号：R454.5[医药卫生—治疗学]