亚低温对重型颅脑损伤患者炎性因子及神经功能的影响  

Influences of mild hypothermia on inflammatory factors and neurological function of patients with severe craniocerebral injury

作　　者：杜彦挺 杜光勇 王晓溪[1] 夏志强[1] 张伟[1] 李涛[1] 

机构地区：[1]榆林市第二医院神经外二科,陕西榆林719000

出　　处：《西南国防医药》2016年第6期608-611,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨亚低温对超低位大骨瓣减压术治疗重型颅脑损伤患者炎性因子及神经功能的影响。方法选择2012年5月-2015年9月86例重型颅脑损伤患者为研究对象,随机分为观察组和对照组各43例,观察组接受亚低温联合大骨瓣减压术治疗,对照组接受大骨瓣减压术治疗,比较两组治疗后的颅内压、血清炎性因子、神经功能、治疗效果。结果在手术后1、3、5、7 d,观察组颅内压均明显低于对照组（P〈0.05）;在术后7 d,观察组C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）含量低于对照组（P〈0.05）;在手术后1个月,观察组CSS评分、NIHSS评分明显低于对照组（P〈0.05）;术后随访6个月,观察组良好率（76.74%）明显高于对照组（55.81%）（P〈0.05）。结论亚低温联合大骨瓣减压治疗有助于降低颅内压,缓解炎症反应程度,改善神经功能,提高治疗效果。Objective To explore the influences of mild hypothermia on inflammatory factors and neurological function of patients with severe craniocerebral injury treated with ultra-low large trauma craniotomy.Methods A total of 86 patients with severe craniocerebral injury treated from May 2012 to September 2015 were selected and randomly divided into an observation group and a control group（n=43）.The observation group was treated with mild hypothcrmia and large trauma craniotomy and the control group with large trauma craniotomy,and then the intracranial pressure,serum levels of inflammatory cytokines,neurologic function and treatment effect of the two groups were compared.Results One,three,five and seven days after the operation,the intracranial pressure of the observation group was much lower than that of the control group（P〈0.05）; seven days after the operation,the content of CRP,TNF-α,IL-6 and IL-8 of the observation group was lower than that of the control group（P〈0.05）; one month after the operation,the CSS score and NIHSS score of the observation group were much lower than those of the control group（P〈0.05）; upon the follow-up six months after the operation,the tolerance rate of the observation group（76.74%） was much higher than that of the control group（55.81%）（P〈0.05）.Conclusion The treatment with mild hypothcrmia and large trauma craniotomy can help reduce the intracranial pressure,relieve inflammatory reaction,improve neurologic function and enhance treatment effect.

关 键 词：颅脑损伤 亚低温 骨瓣 减压 炎性因子 神经功能 

分 类 号：R651.15[医药卫生—外科学]