【摘要】 目的研究亚低温治疗对于重型颅脑损伤的临床疗效及对颅脑损伤患者免疫功能的影响。方法研究重型颅脑外伤患者62例,分为亚低温组和对照组,亚低温组32例,伤后24h内采用亚低温治疗,直肠温度控制在32℃～35℃,持续2～7d,平均74h,同时监测患者的生命体征、颅内压、血电解质、血气分析等。对照组30例,传统的物理及化学方法降温使直肠体温控制在37.8℃～38.5℃,余治疗方法同亚低温组,比较两组患者的并发症发生率和预后。检测两组患者治疗后T淋巴细胞转化功能、NK细胞活性并采用流式细胞术检测外周血T淋巴细胞亚群的动态变化。结果亚低温组较对照组患者,伤后早期颅内压有明显下降,血电解质及酸碱平衡未出现明显紊乱,并发症发生率及死亡率明显下降,优良率提高,预后显著改善。与对照组比较,亚低温组的T淋巴细胞转化率、NK细胞活性及CD4~+CD8~+T淋巴细胞均升高。结论亚低温治疗对于重型颅脑损伤患者安全有效,可降低并发症发生率及死亡率,明显提高患者的生存质量。低温对颅脑伤患者免疫功能具有保护作用。更多还原

【Abstract】 Objective To study the effects of mild hypothennia on the patients of severe brain injury.Methods 62 patients with severe brain injury were divided inkto the hypothermia group (32 cases) and the control group (30 cases).Hypothermia was induced within 24 hours of in- jury.After the rectal temperature reached 32℃～35℃,rewarming was begun 2～7 days (average 74 hours).the vital signs,intracranial pres- sure,blood gas analysis and blood electrolytes were measured.The rectal temperature of the control group was induced to 37.8℃～38.5℃.The mortality and the prognosis was evaluated.Tlymphocyte proliferation,activity of Natural killer cell(NK cell) and dynamic changes of T lympho- cyte subsets were determined.Results In comparison with control group,the increased ICP significantly decreased in hypothermia group.The blood electrolytes and blood gas values did not significantly change.The mortality decreased and the prognosis of the patients improved.Compared with controlled group,proliferation of T lymphocyte,activity of NK cell,T lymphocyte subsets were increased in mild hypothermia group.Conclusion Mild hypothermia is safe and effective for patients with severe brain injury,which can reduce the mortality and improve the prognosis.更多还原