天津医药

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亚低温对脑出血患者立体定向引流术后颅内压及神经保护作用

王冠1,郭家奎1,李冰2,梁伟伦1,董琨1,王增良1   

  1. 1. 天津中医药大学第二附属医院
    2. 天津市环湖医院
  • 收稿日期:2012-10-26 修回日期:2013-01-08 出版日期:2013-04-15 发布日期:2013-04-15
  • 通讯作者: 王冠

The effect of mild hypothermia on the intracranial pressure and neural protection of the patients with intracerebral hemorrhage after stereotactic evacuation

  • Received:2012-10-26 Revised:2013-01-08 Published:2013-04-15 Online:2013-04-15
  • Contact: WANG Guan

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摘要：

【摘要】目的 研究亚低温治疗对脑出血立体定向引流术后患者颅内压（ICP）、S-100B、血糖、神经功能评分及病死率的影响。方法 将入选的47例脑出血（ICH）患者均给予立体定向引流术，术后随机分组并给予常规治疗及亚低温治疗。2组患者于术后连续7 d监测ICP；术后当天及第3、5、7 天检测S-100B、血糖；术后当天及第2、4、12、24和 48周采用欧洲卒中评分量表评估患者的神经功能恢复情况并统计病死率。结果 与常规治疗组比较，亚低温组患者 ICP、S-100B、血糖均显著降低，神经功能评分值提高，2组病死率（17.39% vs 20.83%）差异无统计学意义。结论 亚低温治疗可以降低患者ICP，促进患者神经功能恢复。

关键词: 脑出血, 立体定向引流术, 亚低温, 颅内压

Abstract:

[Abstract] Objective  To investigate the effects of mild hypothermia on the intracranial pressure (ICP), S-100B， blood glucose，mortality and the neural scores in patients with intracerebral hemorrhage (ICH) after stereotactic evacuation. Methods  The patients with ICH were randomly divided into control group (23 patients) and hypothermia group (24 patients) after operation. The treatment group accepted the mild hypothermia. In both group，the ICP was continuously measured in the first week. The S-100B and blood glucose were tested at the day of operation and 3，5 and 7- day after operation. The Neurological Deficit Scale Score was used to evaluate the neural function and mortality in patients at the day of operation and 2，4， 12，24，48-week after operation. Results  Compared with the control group，the values of ICP, S-100B and blood glucose were significantly reduced, and scale score was increased in treatment group. There was no significant difference in the mortal? ity between two groups (17.39% vs 20.83%).Conclusion  The mild hypothermia can assist to improve clinical outcome in patients with ICH after stereotactic evacuation，which is worth further clinical study.

Key words: Intracerebral hemorrhage, Stereotactic evacuation, Mild hypothermia, Intracranial pressure