亚低温治疗弥漫性轴索损伤后脑血管痉挛的疗效观察  

Effect of Mild Hypothermia on the Cerebral Vasospasm After on Diffuse Axonal Injury

作　　者：蒋福生[1] 张平[1] 张新华[1] 

机构地区：[1]南华大学附属南华医院神经内科,湖南衡阳421002

出　　处：《中南医学科学杂志》2013年第5期495-496,504,共3页Medical Science Journal of Central South China

摘　　要：目的探讨亚低温对弥漫性轴索损伤后脑血管痉挛的影响。方法94例弥漫性轴索损伤患者（GCS≤8分）随机分为亚低温组（53例）和常规治疗组（41例）。经颅多普勒（TCD）检测伤后0，1，3，7，14，21天大脑中动脉平均血流速度（VmMCA）。常规治疗组维持正常体温，亚低温组4—8h将肛温降至33℃左右，维持3～5天。分析比较两组大脑中动脉平均血流速度及预后情况。结果两纽患者24h内vmMcA均开始升高，亚低温组患者脑血管痉挛（CVS）发生率低于常规治疗组，亚低温组患者预后好于常规治疗组，两组差异均有统计学意义（P〈0．05）。结论亚低温通过稳定弥漫性轴索损伤后脑循环功能减少脑血管痉挛发生率，从而改善远期预后。Objective To investigate the effect of mild hypothermia on cerebral vasospasm after on diffuse axonal in- jury and its clinical significance. Methods 94 patients with diffuse axonal injury （GCS ≤8 ）were randomly divided into the conventional therapy group with 41 patients and the mild hypothermia therapeutic group with 53 patients. The blood flow velocity of middle cerebral artery （VmMCA） was measured after diffuse axonal injury with the Transcranial Doppler （TCD） at the days O, 1,3,7,10,14,21. The changing phase of the blood flow VmMCA and prognosis were compared and analyzed. Results The blood flow velocity in the middle cerebral artery （MCA） during 24 h after injury was getting faster. The in- cidence rate in cerebral vasospasm of the conventional therapy group was significantly higher than that in the mild hypother- mia therapeutic group. The rate of favorable prognosis in mild hypothermia therapeutic group was better than that in conven- tional therapy group. The difference between the two groups were statistically significant （ P 〈 0.05 ）. Conclusion Mild hypothermia treatment can reduce incidence of cerebral ospasm by stabilizing cerebral circulation after diffuse axonal injury and improve the future prognosis.

关 键 词：弥漫性轴索损伤 亚低温 脑血管痉挛 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]