亚低温疗法联合依达拉奉治疗重症颅脑损伤患儿的临床疗效  

Effects of mild hypothermia therapy combined with edaravone in the treatment of children with severe cranial injury

作　　者：袁博[1] 孙文武[1] 王宇艳 Yuan Bo;Sun Wen-wu;Wang Yu-yan(Children's Intensive Care Unit,Nanyang First People's Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第一人民医院儿童重症监护室,河南南阳473000

出　　处：《四川生理科学杂志》2024年第3期562-565,579,共5页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨亚低温疗法联合依达拉奉治疗重症颅脑损伤(Severe craniocerebral injury,SCCI)患儿的临床疗效,及对患儿神经功能、血液流变学、炎性因子、预后的影响.方法:选取南阳市第一人民医院2019年1月至2022年12月收治的98例SCCI患儿为研究对象,随机数字表法将患儿分为常规组和联合组(n=49),分别进行对症抢救及对症+亚低温疗法联合依达拉奉治疗.治疗2 w后,比较两组临床疗效和不良反应,采用美国国立卫生院卒中评分量表(National Institutes of Health stroke scale,NIHSS)评估患者的神经功能,采用格拉斯哥预后量表(Glasgow outcome scale,GOS)评估患者的预后恢复状况,采用全自动血液流变仪检测患者的血液流变学指标(血浆黏度、全血低切黏度、全血高切黏度、血沉),酶联免疫吸附法检测超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(Interleukin-6,IL-6)、泛素羧基末端水解酶Ll(Ubiquitin C-terminal hydrolase-L1,UCH-L1)、纤维胶凝蛋白3(Ficolin3,FCN3)水平.结果:治疗2 w后,联合组(93.88%)临床总有效率高于常规组(79.59%)(P<0.05);联合组NIHSS评分低于常规组,GOS评分高于常规组(P<0.05);联合组血浆黏度、全血低切黏度、全血高切黏度、血沉、血清hs-CRP、IL-6、UCH-L1水平明显低于常规组,FCN3水平明显高于常规组(P<0.05);两组不良反应发生率比较,无显著差异(P>0.05).结论:亚低温疗法联合依达拉奉治疗SCCI患儿疗效显著,可有效改善血液流变学,减轻神经损伤,抑制炎症反应,安全性较好.Objective:To investigate the clinical efficacy of mild hypothermia therapy combined with edaravone in the treatment of children with severe craniocerebral injury(SCCI),and its effects on neurological function,hemorheology,inflammatory factors,and prognosis.Methods:Ninety-eight children with SCCI admitted to Nanyang First People's Hospital from January 2019 to December 2022 were selected as the study objects.The children were divided into a routine group and a combination group(n=49)by random number table method,they received symptomatic rescue treatment and symptomatic rescue treatment+mild hypothermia combined with edaravone,respectively.After 2 weeks of treatment,the clinical efficacy and adverse reactions were compared between the two groups,National Institutes of Health stroke scale(NIHSS)was used to estimate the neurological function,Glasgow outcome scale(GOS)was used to estimate the prognosis and recovery status,automatic blood Rheometer was used to detect the hemorheological indicators(plasma viscosity,whole blood low tangential viscosity,whole blood high tangential viscosity,erythrocyte sedimentation rate),enzyme-linked immunosorbent assay was used to measure the inflammatory factors,including hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),ubiquitin C-terminal hydrolyse-L1(UCH-L1),ficolin 3(FCN3).Results:After 2 weeks of treatment,the total effective rate of the combination group(93.88%)was higher than that of the routine group(79.59%)(P<0.05).The NIHSS score in the combination group was lower than that in the routine group,GOS score was higher than that in the routine group(P<0.05).Plasma viscosity,whole blood low shear viscosity,whole blood high shear viscosity,erythrocyte sedimentation rate,and serum levels of hs-CRP,IL-6,and UCH-L1 in the combination group were significantly lower than those in the routine group,and FCN3 level was significantly higher than that in the routine group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P

关 键 词：亚低温疗法 依达拉奉 重症颅脑损伤 脑神经功能 

分 类 号：R651.15[医药卫生—外科学]