靶向温度管理对重型脑损伤患者脑细胞功能、吞咽功能及神经功能重建介质的影响  

The effects of targeted temperature management on brain cell function,swallowing function and the mediators ofnerve function reconstruction in patients with severe traumatic brain injury

作　　者：王巧琳 何芙蓉 简福霞 WANG Qiao-lin;HE Fu-rong;JIAN Fu-xia(Department of Neurosurgery,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Department of Intensive Care Unit,Wound Trauma Medical Center,Army Medical University,Chongqing 400042,China)

机构地区：[1]成都医学院第一附属医院神经外科,四川成都610500 [2]陆军军医大学大坪医院战创伤医学中心重症医学科,重庆400042

出　　处：《实用医院临床杂志》2021年第4期141-144,共4页Practical Journal of Clinical Medicine

摘　　要：目的研究靶向温度管理对重型脑损伤(STBI)患者脑细胞功能、吞咽功能及神经功能重建介质的影响。方法选取2016年7月至2020年6月于成都医学院第一附属医院接受治疗的STBI患者92例,按照随机数字表法分为靶向温度管理(TTM)组与对照组各46例。对照组给予常规管理,TTM组在对照组基础上进行TTM。观察两组治疗前及治疗后1、3、5天的颅内压(ICP);血清髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)等脑细胞功能指标;吞咽功能;血清神经生长因子(NGF)、脑源性神经生长因子(BDNF)等神经功能重建介质。结果治疗1、3、5天TTM组ICP均低于对照组(P<0.01);治疗后TTM组血清MBP、NSE、GFAP水平低于对照组,SAA评分小于对照组,血清NGF、BDNF水平高于对照组(P<0.01)。结论TTM可降低STBI患者ICP,维持其脑细胞功能、吞咽功能,促进分泌神经功能重建介质,诱导患者神经功能重建。Objective To investigate the effect of targeted temperature management(TTM)on brain cell function,swallowing function and mediators of nerve function reconstruction in patients with severe traumatic brain injury(STBI).Methods A total of 92 STBI patients admitted to our hospital from July 2016 to June 2020 were involved in this study.The patients were divided into TTM group and control group using the random number table method,46 in each group.The control group was given routine management and the TTM group was given TTM.Intracranial pressure(ICP)of STBI patients before and after 1 day,3 and 5days after treatment were observed.Before and after treatment,indexes of brain cell function such as serum myelin basic protein(MBP),neuron specific enolase(NSE)and glial fibrillary acidic protein(GFAP),swallowing function,mediators of nerve function reconstruction such as serum nerve growth factor(NGF)and brain derived nerve growth factor(BDNF)were observed in the two groups.Results After1 day,3 and 5daysof treatment,ICP of STBI patients in the TTM group were lower than that in the control group(P<0.05).After treatment,the serum MBP,NSE and GFAP of STBI patients in the TTM group were lower than those in the control group(P<0.05).The SAA score of STBI patients in the TTM group were lower than that in the control group.The serum NGF and BDNF in the TTM group were higher than that in the control group(P<0.05).Conclusion TTM can reduce the ICP of STBI patients,maintain the brain cell function and swallowing function,promote the secretion of mediators of nerve function reconstruction,and induce the nerve function reconstruction.

关 键 词：靶向温度管理 重型脑损伤 脑细胞功能 吞咽功能 神经功能重建介质 

分 类 号：R641[医药卫生—外科学]