摘要
目的 探讨院前亚低温治疗对重型颅脑损伤患者的临床疗效,并通过患者血清氧自由基丙二醛（MDA）的变化探讨可能机制.方法 120例重型颅脑损伤患者按随机数字表法分为院前亚低温组（A组,65例）和对照组（B组,55例）.A组院前即给予亚低温治疗,而B组仅在入院后给予亚低温治疗.比较两组入院时、第7天及第14天血清MDA变化,采用GOS评分比较6个月后疗效.结果 两组第7、14天的MDA水平[A组（10.4±1.5） nmol/L、（8.2±1.2） nmol/L,B组（12.6±1.9）nmol/L、（10.0±1.4）nmol/L]均高于入院时[A组（6.9±1.1）nmol/L,B组（6.6±1.0）nmol/L],以第7天时最高,且A组在第7、14天时均明显低于B组（t=2.337、2.512,均P＜0.05）；A组患者预后良好率为47.7％（31例）,高于B组的38.2％（21例）,而病死率为12.1％（8例）,低于B组的21.4％（12例）,差异有统计学意义（Z=-2.132,P＜0.05）.结论 院前亚低温治疗能改善重型颅脑损伤预后,减轻脑组织损伤.
Objective To investigate the clinical efficacy of pre-hospital mild hypothermia in patients with severe craniocerebral injury, and to explore the possible mechanism by the changes of serum Malondialdehyde （MDA）. Methods 120 cases of severe craniocerebral injury were divided into pre-hospital mild hypothermia group （group A,65 cases） and control group（ group B,55 cases） by random number table. Patients in group A were gave pre-hospital mild hypothermia treatment, and patients in group B were gave mild hypothermia therapy only after hospi- talization. Comparison of the change of serum MDA at admission, the 7th and 14th day between two groups, and the functional outcomes were evaluated by GOS score in 6 months after treatment. Results The MDA levels of two group at seventh days and 14 days were higher than that at admission[ （ 10.4 ±1.5 ） nmol/L and （ 8.2 ± 1.2） nmol/L in group A, （12.6 ± 1.9）nmol/L and （10.0 ± 1.4）nmol/L in group B, P 〈 0.05 ], and it was the highest at 7th day, and its in group A was significantly lower than that in group B at 7th, 14th day[ （6.9 ± 1.1 ） nmol/L in group A, （6.6 ± 1.0）nmol/L in group B,P 〈0.05]. The good prognosis rate was 47.7% （31 cases） in group A,higher than the 38.2% （21 cases） in group B;The mortality rate was 12.1% （8 cases） in group A,lower than the 21.4% （ 12 cases） the group B, and the difference was statistically significant （Z = - 2.132, P 〈 0.05 ）. Conclusion Pre-hospital mild hypothermia treatment can improve the prognosis of patients with severe craniocerebral injury and alleviate the damage of brain tissues.
出处
《中国基层医药》
CAS
2013年第19期2883-2885,共3页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省杭州市医疗卫生科研项目（20120533Q22）
关键词
脑损伤
低温
人工
自由基
预后
Brain injuries
Hypothermia, induced
Free radicals
Prognosis
