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目的 观察亚低温治疗重症脑血管病的疗效。方法 62例重症脑血管病患者 ,随机分为亚低温组和对照组 ,亚低温组应用冰毯机将患者肛温控制在 3 4～ 3 5℃达 48h ,并于治疗前、治疗开始后第 2天、第 5天、第 7天对两组患者进行格拉斯哥昏迷评分 (glasgowcomascale ,GCS) ,同时于治疗前、治疗开始后第 2周、第 4周、第 1 2周进行神经功能缺损评分 ,监测患者生命体征 ,记录治疗中出现的副反应及死亡率。结果 治疗组 3 0例患者治疗前及治疗后 2d、5d、7dGCS分别为 7.60、8.3 5、1 3 .3 9、1 4.2 7;对照组相应数值分别为 7.52、8.1 6、9.40、1 0 .1 8;治疗组治疗前及治疗后 2周、4周、1 2周神经功能缺损评分分别为45.2 7、3 5.79、1 7.3 6、1 4.1 2 ;对照组相应数值分别为 45.52、3 7.46、2 9.70、2 5.3 5;治疗组与对照组死亡率分别为 7.3 3 %和 2 8.1 2 % (P <0 .0 5)。两组治疗后第 5天、第 7天GCS相比较 ,治疗组明显好于对照组 (P <0 .0 5) ;两组治疗后第 4周、第 1 2周神经功能缺损评分相比较治疗组也明显好于对照组 (P <0 .0 5)。治疗组出现明显副反应。结论 亚低温治疗能有效保护重症脑血管病患者的脑细胞 ,降低死亡率 ,改善脑卒中患者的预后。
Objective To observe the therapeutic effect of mild hypothermia on severe cerebrovascular disease. Methods Sixty-two patients with severe cerebrovascular disease were randomly divided into mild hypothermia group and control group. In the mild hypothermia group, the rectal temperature was controlled at 34 to 35 ℃ for 48 hours in the mild hypothermia group. Before treatment, Glasgow coma scale (GCS) was measured on the 2nd day, the 5th day and the 7th day in both groups. At the same time, neurological deficit scores were evaluated before treatment, at the 2nd week, the 4th week and the 12th week after the start of the treatment, Monitor patient vital signs and record side effects and mortality rates during treatment. Results Before treatment and 2d, 5d and 7d after treatment, the GCS of 30 patients in the treatment group were 7.60, 8.35, 13.3, and 13.72, respectively. The corresponding values in the control group were 7.52, 8.16, 9.40 and 10 respectively. The score of neurological deficit in the treatment group before treatment and 2 weeks, 4 weeks and 12 weeks after treatment were 45.27,3 5.79,1 7.36,1 4.1 2 respectively; the corresponding values in the control group were 45.52 and 7.46, 2 9.70,25.35; the mortality rates of the treatment group and the control group were 7.33% and 2 8.12% (P <0.05) respectively. The GCS of the 5th day and the 7th day after treatment in the two groups were significantly better than those in the control group (P <0.05). The scores of neurological deficits in the 4th and 12th week after treatment in both groups were significantly higher than those in the control group Group was also significantly better than the control group (P <0. 05). The treatment group showed obvious side effects. Conclusion Mild hypothermia treatment can effectively protect brain cells in patients with severe cerebrovascular disease, reduce mortality and improve the prognosis of patients with stroke.