[1]包　贇,邱炳辉,曾　浩,等.重型颅脑损伤去骨瓣减压术后颅内压升高的亚低温治疗[J].中国临床神经外科杂志,2016,(11):657-660.[doi:10.13798/j.issn.1009-153X.2016.11.001]
　BAO Yun,QIU Bing-hui,ZENG Hao,et al.Mild hypothermia treatment of intracranial hypertension after decompressive craniectomy in patients with severe traumatic brain injury[J].,2016,(11):657-660.[doi:10.13798/j.issn.1009-153X.2016.11.001]
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重型颅脑损伤去骨瓣减压术后颅内压升高的亚低温治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年11期
页码:
657-660
栏目:
论著
出版日期:
2016-11-25

文章信息/Info

Title:
Mild hypothermia treatment of intracranial hypertension after decompressive craniectomy in patients with severe traumatic brain injury
文章编号:
1009-153X（2016）11-0657-04
作者:
包　贇; 邱炳辉; 曾　浩; 莫益萍; 邱晓瑜; 漆　敏; 周立志; 漆松涛
510515 广州，南方医科大学南方医院神经外科（包　贇、邱炳辉、曾　浩、莫益萍、邱晓瑜、漆　敏、周立志、漆松涛）
Author(s):
BAO Yun;  QIU Bing-hui;  ZENG Hao;  MO Yi-ping;  QIU Xiao-yu;  QI Min;  ZHOU Li-zhi;  QI Song-tao.
Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
关键词:
重型颅脑损伤; 去骨瓣减压术; 颅内压升高; 亚低温治疗; 疗效
Keywords:
Severe traumatic brain injury;  Intracranial hypertension;  Decompressive craniectomy;  Mild hypothermia
分类号:
R 651.1+5;R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.11.001
文献标志码:
A
摘要:
目的 探讨亚低温治疗对重型颅脑损伤去骨瓣减压术后持续性颅内压升高的效果及安全性。方法 回顾性分析48例重型颅脑损伤去骨瓣减压术后仍存在持续性颅内压升高的临床资料，根据减压术后治疗方法分为亚低温组（22例，进行亚低温治疗）和常温组（26例，维持正常体温）。结果 与术后1 d相比，术后2~4 d，两组颅内压均呈明显下降趋势（P<0.05），脑灌注压均呈明显增高趋势（P<0.05），而且亚低温组变化更明显（P<0.05）。亚低温组肺部感染和水电解质紊乱发生率均明显高于常温组（P<0.05）。伤后6个月，亚低温组GOS评分1分2例，2分8例，3分4例，4分2例，5分6例；常温组1分8例，2分10例，3分4例，5分4例；两组预后无统计学差异（P>0.05）。结论 亚低温治疗能有效缓解重型颅脑损伤去骨瓣减压术后颅内压增高。
Abstract:
Objective To evaluate the curative effects of mild hypothermia on the intracranial hypertension after the decompressive craniectomy and its safety in patients with severe traumatic brain injury (sTBI). Methods The clinical data of 48 sTBI patients with intracranial hypertension after the decompressive craniectomy, who were divided into mild hypothermia group (n=22) and control group (n=26), were analyzed retrospectively. The curative effects were compared between both the groups. Results The intracranial pressures (ICPs) 2, 3 and 4 days after the operation were (21.09±1.18) mmHg, (19.09±0.74) mmHg and (18.27±0.88) mmHg respectively in the mild hypothermia group and (27.00±1.16) mmHg, (25.26±1.13) mmHg and (21.80±1.37) mmHg respectively in the control group. The cerebral perfusion pressures (CCPs) 2 and 3 days after the operation were (75.63±0.82) mmHg and (77.18±1.23) mmHg respectively in mild hypothermia group and (69.88±1.85) mmHg and (71.42±2.03) mmHg respectively in the control group. There were significant differences in the above-mentioned ICPs and CCPs between the two groups (P<0.05). The rates of pulmonary infection (54.5%, 12/22) and electrolyte disturbances (59.1%, 13/22) were significantly higher in the mild hypothermia group than those [(23.1%, 6/26) and (26.9%, 7/26) respectively] in the control group (P<0.05). Conclusions The results suggested that mild hypothermia therapy can lower the intracranial hypertension after the decompressive craniectomy and probably increase the risks of pulmonary infection and electrolyte disturbances in the patients with TBI.

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备注/Memo

备注/Memo:
基金项目：南方医科大学南方医院院长基金（2013B017；2015C028）；广东省科技计划项目（2013B021800304）
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更新日期/Last Update: 2016-11-25