头部轻度低温治疗高血压性脑出血的临床疗效  

Clincal efficacy of head mild hypothermia in treatment of hypertensive intracerebral hemorrhage

作　　者：徐林新[1] 李新立[1] 张效东[1] 吴秀芳 张晓明[1] 

机构地区：[1]中国人民解放军第一五九医院神经内科,河南驻马店463008

出　　处：《中华老年心脑血管病杂志》2002年第5期327-329,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的　观察颅脑降温治疗仪头部轻度低温对高血压脑出血患者脑血流动力学、血肿周围水肿和临床疗效的影响。方法　 5 8例高血压脑出血随机分为治疗组和对照组 ,在给予脑出血常规治疗的同时 ,治疗组加用电子冰帽。观察血肿体积 ,血肿周围水肿体积 ,病灶侧大脑中动脉平均血流速度 (Vm)和脉动指数 (PI) ,神经功能缺损评分。结果　治疗后第 2 1天治疗组和对照组血肿周围水肿体积分别为 (13.4 3± 12 .6 )ml,(19.6 5± 11.73)ml,(P <0 .0 1)。治疗后第 7天治疗组和对照组Vm分别为 (43.35± 6 .2 8)cm s,(41.87± 6 .17)cm s,(P <0 .0 5 ) ;治疗后第 2 1天治疗组和对照组Vm分别为 (5 9.82± 8.92 )cm s ,(5 6 .78± 8.4 5 )cm s ,(P <0 .0 1)。治疗后第 2 1天治疗组和对照组神经功能缺损评分分别为 2 0 .6 4± 14 .31、2 4 .6 9± 13.2 3,(P <0 .0 1)。结论　颅脑降温治疗仪使头部轻度低温能减轻高血压脑出血血肿周围水肿 ,有利于血肿区Vm的恢复 。Objective To observe the effect of head mild hypothermia(MHT) induced by the head temperature control instrument on peri hematomal edema and hemodynamics after hypertensive intracerebral hemorrhage(HIH) and its therapeutic efficacy.Methods Fifty eight cases of HIH were selected.Of them,30 cases served as control and 28 cases were treated with selective head MHI induced by head temperature control instrument.The volumes of hematoma and peri hematomal edema were measured by CT.The mean blood flow velocity(Vm)in the middle cerebral artery(MCA)and pulsatility index(PI)were measured by TCD.Neurological deficiency score(NDS)was assessed.Results The volume of peri hematomal edema was(13.43±2.67) ml and (19.63± 11.73 ) ml in treated group and control group on day21 after treatment(P<0.01),respectively.Vm was(43.35±6.28) cm/s and (41.87± 6.17 ) cm/s in treated group and control on day7(P<0.05),respectively and ( 59.82 ±8.92) cm/s,(58.78±8.45) cm/s in treated group and control on day21(P<0.01) after treatment,respectively.NDS was 20.61±14.31 and 24.69±13.23 in treatcd group and control on day21 after treatment(P< 0.01 ),respectively.Conclusion The selective head mild hypothermia induced by head temperature control instrument can reduce the peri hematomal edema and improve Vm and NDS of the patients.

关 键 词：头部 轻度低温治疗 高血压性脑出血 临床疗效 血液动力学 神经功能缺损 

分 类 号：R743.34[医药卫生—神经病学与精神病学]