早期机械通气配合亚低温治疗重型颅脑损伤的疗效及对血清C反应蛋白和血液流变学的影响  

The effect of early mechanical ventilation combined with mild hypothermia in the treatment of severe brain injury and its effect on serum C-reactive protein and hemorheology

作　　者：许燕凯[1] 吴晋[1] 马少玲 徐声亮[1] 罗成[1] 

机构地区：[1]汕头大学医学院第一附属医院神经外科,广东省汕头515041 [2]汕头市120急救指挥中心,广东省汕头515031

出　　处：《中国基层医药》2016年第17期2613-2616,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨早期机械通气配合亚低温治疗重型颅脑损伤（STBI）的临床疗效及对患者血清 C 反应蛋白（CRP）和血液流变学的影响。方法将110例 STBI 患者选为研究病例，按照入院顺序将其分为两组，均给予常规对症治疗，对照组55例采取早期机械通气，观察组55例采取早期机械通气配合亚低温治疗。比较临床疗效。结果观察组预后良好率74．55％，较对照组的56．36％明显提高（χ^2＝7．65，P ＜0．05）。观察组入院第2、3、5、7天时血清 CRP 与对照组比较均明显减少（t ＝7．48、8．04、7．34、7．82，均 P ＜0．05）。观察组治疗后30 d 时全血高切黏度（6．03±0．89）mPa／s、全血低切黏度（3．18±0．19）mPa／s、血浆黏度（1．21±0．18）mPa／s、红细胞比容（37．56±3．23）％与治疗前比较明显减少（t ＝8．45、7．54、7．04、8．02，均 P ＜0．05）；且与对照组差异均有统计学意义（t ＝7．77、6．69、6．44、7．49，均 P ＜0．05）。结论早期机械通气配合亚低温治疗 STBI 疗效显著，可降低血清 CRP 水平，改善血液流变学指标，有利于患者预后。Objective To explore the clinical effect of early mechanical ventilation coupled with mild hypothermia in the treatment of severe traumatic brain injury（STBI）and its effect on serum C -reactive protein （CRP）and hemorheology.Methods According to the order of admission,110 patients with STBI were divided into two groups.55 cases in the control group were given conventional symptomatic treatment and early mechanical ventilation, while 55 patients in the observation group were given early mechanical ventilation coupled with mild hypothermia.The clinical efficacy was compared between the two groups.Results The good prognosis rate was 74.55% in the observation group,which was significantly higher than 56.36% of the control group （χ^2 =7.65,P 〈0.05）.The serum CRP in the observation group admitted to hospital 2,3,5,7d were significantly decreased compared with the control group（t =7.48,8.04,7.34,7.82,all P 〈0.05）.After treatment,the hear whole blood viscosity was （6.03 ±0.89）mPa·s, low shear whole blood viscosity was （3.18 ±0.19）mPa·s,plasma viscosity was （1.21 ±0.18）mPa·s,hematocrit was （37.56 ±3.23）%,and those were decreased compared with before treatment（t =8.45,7.54,7.04,8.02,all P 〈0.05）.And there were significant differences compared with the control group（t =7.77,6.69,6.44,7.49,all P 〈0.05）.Conclusion The effect of early mechanical ventilation coupled with mild hypothermia in the treatment of STBI has good effect,and it can reduce serum CRP levels,improve blood rheology,which is conducive to patients＇ prognosis.

关 键 词：颅脑损伤 通气机 机械 低温 C 反应蛋白质 血流动力学 

分 类 号：R651.15[医药卫生—外科学]