摘要
目的：观察亚低温治疗对重型颅脑损伤（STBI）患者血清中降钙素原（PCT）和白介素-6（IL-6）水平的影响。方法：96例STBI患者均分为亚低温治疗组与对照组,两组患者均给常规对症治疗,对照组在治疗过程中使患者体温维持在36.5～37.5℃;亚低温治疗组患者使用亚低温治疗仪及其他降温措置使患者体温维持在32～35℃;观察亚低温治疗组患者治疗前和治疗后24 h、48 h、72 h、168 h及复温时的颅内压,并与同时点对照组的颅内压比较;分别于治疗前和治疗后24 h、72 h及168 h时,采用酶联免疫吸附试验测定2组患者血清IL-6及PCT水平;观察两组患者治疗后6个月时并发症和好转率。结果：治疗前和治疗24 h时,两组患者颅内压及血清PCT、IL-6水平比较,差异无统计学意义（P〉0.05）;治疗后48 h、72 h及168 h及复温后亚低温治疗组患者颅内压低于对照组患者（P〈0.05）,治疗后72 h和168 h时亚低温治疗组患者PCT、IL-6水平低于对照组患者（P〈0.05）;亚低温治疗组治疗后6个月时均未发生严重的并发症,对照组中有2例发生应激性溃疡,1例发生癫痫;亚低温治疗组治疗后6个月时好转率高于对照组（P〈0.05）。结论：亚低温治疗可以降低STBI患者颅内压,效果明显,其机制可能与降低血清中PCT、IL-6的水平有关。
Objective： To observe the effects of mild hypothermia on serum interleukin-6（ IL-6） and procalcitonin（ PCT） levels in patients with severe traumatic brain injury（ STBI）. Methods： A total of96 STBI patients were randomly divided into mild hypothermia treatment group and control group,all the patients were given conventional symptomatic treatment,maintaining the temperature of the patients in control group at 36. 5 ~ 37. 5 ℃ in the treatment process,maintaining the temperature of the patients in mild hypothermia treatment group at 32 ~ 35 ℃ through mild hypothermia therapeutic instrument and physical cooling method in the treatment process. Intracranial pressure before treatment and24,48,72,168 h after treatment and at the time of rewarming were observed. The serum levels of PCT and IL-6 were measured,complication and improvement rate in 6 months after treatment were compared between the two groups. Results： No significant difference was found in intracranial pressure and serum levels of PCT and IL-6 between the two groups before therapy and 24 h after therapy（ P 〈0. 05）. Intracranial pressure of mild hypothermia treatment group in 48,72,168 h after treatment was lower than that of control group（ P 〈0. 05）,the serum levels of PCT and IL-6 of mild hypothermia treatment group in 72,168 h after treatment was lower than that of control group（ P〈 0. 05）. No serious complication happened in mild hypothermia treatment group in 6 months after treatment. In the control group,there were 2 cases of stress ulcer,1 case of epilepsy. The improvement rate of mild hypothermia treatment group was higher than that of control group（ P〈 0. 05）. Conclusion： Mild hypothermia treatment can reduce intracranial pressure effectively,the mechanism may relate to decreasing the serum levels of PCT and IL-6.
作者
陆皓
万意
LU Hao WAN Yi(Department of Cerebral Surgery, the 7th People＇s Hospital of Suzhou City, Suzhou 215151, Jiangsu , China Department of Neurosurgery , Suzhou Kowloon Hospital, Suzhou 215000, Jiangsu , China)
出处
《贵州医科大学学报》
CAS
2016年第10期1220-1223,共4页
Journal of Guizhou Medical University
基金
江苏省基础研究计划(自然科学基金)面上研究项目(BK2011341)
关键词
脑损伤
降钙素原
白细胞介素6
治疗结果
亚低温
手术后并发症
brain injury
procalcitonin
interleukin-6
therapeutic outcome
mild hypothermia
complication after surgery
