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目的:比较亚低温与常温治疗重型颅脑损伤患者的临床效果。方法:选取入住ICU病区的重型颅脑损伤患者72例,随机分为亚低温组(n=36)接受32~35℃低温治疗,对照组(n=36)体温维持在(37±0.5)℃,观察其临床疗效。结果:随访6个月,对照组死亡13人,植物状态2人,重度残疾4人,轻度残疾7人,良好康复10人,亚低温治疗组死亡5人,植物状态1人,重度残疾2人,轻度残疾13人,良好康复15人,亚低温治疗组伤后6个月死亡率较对照组降低(x~2=4.471,P=0.029),且良好神经系统转归明显高于对照组(x~2=7.170,P=0.007)。亚低温治疗组血清中S-100B蛋白含量在治疗后3~7 d低于对照组,差异有统计学意义(P<0.05)。结论:在常规治疗基础上联合亚低温治疗对重型颅脑损伤患者具有脑保护作用并能降低死残率。
Objective: To compare the clinical effects of mild hypothermia and normal temperature in patients with severe traumatic brain injury. Methods: Seventy-two patients with severe craniocerebral injury who were admitted to intensive care unit (ICU) were randomly divided into mild hypothermia group (n = 36) and low temperature group (32-35 ℃). The body temperature of the control group (n = 36) ℃, observe its clinical efficacy. Results: At the 6-month follow-up, there were 13 deaths in the control group, 2 in plant status, 4 with severe disability, 7 with mild disability, 10 with good rehabilitation, 5 with mild hypothermia, 1 with plant disease, 2 with severe disability 13 people with moderate disability and 15 persons recovered well. The death rate of the mild hypothermia treatment group at 6 months after injury was lower than that of the control group (x 2 = 4.471, P = 0.029), and the good neurological outcome was significantly higher than that of the control Group (x ~ 2 = 7.170, P = 0.007). The serum levels of S-100B protein in the mild hypothermia group were lower than those in the control group 3 to 7 days after treatment (P <0.05). Conclusion: Combined with mild hypothermia on the basis of routine treatment, it can protect brain in patients with severe craniocerebral injury and reduce the mortality rate.