亚低温对重型颅脑损伤患者脑氧代谢及脑损伤程度的影响  

Effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury

作　　者：汪江[1] 杨亚东[1] 佘秋芳 陈桂芬 

机构地区：[1]湖北省黄冈市中心医院重症医学科,湖北黄冈438000 [2]福建中医药大学人文与管理学院,福建福州350122

出　　处：《海南医学院学报》2018年第1期133-137,共5页Journal of Hainan Medical University

基　　金：湖北省黄冈市卫生局一般规划项目(HW-2009BNO.017)~~

摘　　要：目的:探讨亚低温对重型颅脑损伤患者脑氧代谢及脑损伤程度的影响。方法:选择送至黄冈市中心医院进行急诊治疗的重型颅脑损伤患者78例作为研究对象,经随机数表法分为对照组、亚低温组各39例。对照组接受临床重型颅脑损伤患者标准外伤大骨瓣开颅术治疗,亚低温组接受常规手术及术后亚低温治疗。检测两组入院即刻(T0)、入院治疗后1周(T1)、入院治疗后4周(T2)的脑氧代谢及脑损伤程度。结果:T0时,两组患者的脑氧代谢指标、脑血流参数、脑损伤标志物水平差异无统计学意义。T1、T2时,亚低温组PO_2的水平较对照组高,Da-jvO_2的水平较对照组低;脑血流参数Vs、Wv的水平较对照组高,PI的水平较对照组低;脑损伤标志物MBP、AQP-4、S-100B的含量较对照组低,BDNF的含量较对照组高。结论:重型颅脑损伤患者在常规手术治疗后辅助应用亚低温治疗,可进一步降低脑氧代谢并减轻脑损伤。Objective:To investigate the effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury.Methods:A total of 78 patients with severe craniocerebral injury who underwent emergency treatment in Huanggang Central Hospital between September 2015 and May 2017 were selected as the research subjects and divided into control group(n=39)and mild hypothermia group(n=39)by random number table.Control group received clinical standard large trauma craniotomy for severe craniocerebral injury,and mild hypothermia group received routine surgery and postoperative mild hypothermia therapy.The cerebral oxygen metabolism and brain injury in two groups of patients were detected immediately after admission(T0),1 week after treatment(T1)and 4 weeks after treatment(T2).Results:At T0,there was no statistically significant difference in the levels of cerebral oxygen metabolism indexes,cerebral blood flow parameters and brain injury markers between the two groups.At T1 and T2,PO_2 levels in mild hypothermia group were higher than those in control group while Da-jvO_2 levels were lower than those in control group;cerebral blood flow parameters Vs and Wv levels were higher than those in control group while PI levels were lower than those in control group;brain injury markers MBP,AQP-4 and S-100 Bcontents were lower than those in control group while BDNF contents were higher than those in control group.Conclusion:Adjuvant mild hypothermia therapy after routine surgery may further reduce the cerebral oxygen metabolism and relieve the brain injury in patients with severe craniocerebral injury.

关 键 词：重型颅脑损伤 亚低温 脑氧代谢 脑损伤 

分 类 号：R651.15[医药卫生—外科学]