论文部分内容阅读
目的:研究亚低温治疗老年急性重度颅脑损伤患者的神经功能改善及血流动力学改变。方法:选择2012-05-2015-07我院接诊的92例老年急性重度颅脑损伤患者进行研究,随机分为观察组和对照组,每组各46例。对照组给予常规治疗,观察组采用亚低温治疗。观察组患者进行24~72h的亚低温治疗。对比分析2组患者神经功能评分(GCS)和血流动力学评分情况,并记录不良反应发生情况。结果:2组患者颅脑损伤和临床特征情况比较差异无统计学意义;2组患者的收缩期血流速度(Vs)、平均血流速度(Vm)和搏动指数(PI)在1d的时候无明显变化,在之后3d、5d、10d观察组的Vs、Vm和PI和对照组相比较有较明显改善,2组比较差异有统计学意义(P<0.05);2组患者的GCS评分在1d和3d并无明显差异,但在5d、7d观察组GCS评分要明显好于对照组,在10d达到最高(10.43±3.33)分vs.(8.23±3.23)分,2组比较差异有统计学意义(P<0.05)。2组不良反应发生率差异无统计学意义。结论:亚低温治疗老年急性重度颅脑损伤患者效果良好,可以显著改善患者的血流动力学指标,对患者的脑组织具有一定的保护作用,值得在临床推广和应用。
Objective: To study the improvement of neurological function and hemodynamic changes in mild hypothermia in elderly patients with acute severe traumatic brain injury. Methods: A total of 92 elderly patients with severe acute brain injury admitted to our hospital from 2012-05-2015-07 were selected and randomly divided into observation group and control group, with 46 cases in each group. The control group was given routine treatment, and the observation group was treated with mild hypothermia. Patients in the observation group were treated with mild hypothermia for 24 ~ 72 hours. The neurological function scores (GCS) and hemodynamic scores of two groups were compared and recorded, and the incidence of adverse reactions was recorded. Results: There was no significant difference between the two groups in traumatic brain injury and clinical features. The systolic velocity (Vs), mean velocity (Vm) and pulsatility index (PI) of the two groups were not significantly different at 1 day Vs, Vm and PI in the observation group after 3d, 5d, 10d were significantly improved compared with the control group, there was significant difference between the two groups (P <0.05); The GCS score of the two groups in 1d (P <0.05). The GCS score of the observation group on the 5th and 7th days was significantly better than that of the control group, reaching the highest (10.43 ± 3.33) points vs (8.23 ± 3.23) points on the 10th day. The difference between the two groups was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion: Mild hypothermia in elderly patients with acute severe traumatic brain injury has a good effect, which can significantly improve hemodynamic parameters in patients with brain tissue of patients with some protective effect, it is worth in the clinical promotion and application.