【摘要】 目的比较全身亚低温与局部亚低温对于高血压性脑出血患者的临床疗效。方法将96例高血压性脑出血患者随机分为全身亚低温治疗组(30例)、局部亚低温治疗组(36例)和对照组(30例)。在给予脑出血常规治疗的同时,全身亚低温治疗组加用全身亚低温(电子冰毯)治疗,局部亚低温治疗组加用头颅局部亚低温(电子冰帽)治疗。观察脑内血肿体积、血肿周围水肿体积及神经功能缺失评分的变化。结果人组后7 d 各组的血肿体积、血肿周围水肿体积及神经功能缺失评分无显著性差异。入组后14 d 时,全身亚低温治疗组血肿体积(14.22±14.06 ml)较局部亚低温治疗组(20.54±16.41 ml)和对照组(22.26±13.20 ml)显著缩小(P<0.05);全身亚低温治疗组血肿周围水肿体积(16.25±12.31 ml)和局部亚低温治疗组(22.01±12.08ml)血肿周围水肿体积均与对照组(28.21±10.02 ml)相比,均有显著缩小(均为 P<0.01),而全身治疗组与局部治疗组相比亦有显著改善(P<0.01);入组后14 d 时全身治疗组与局部治疗组的神经功能缺失评分(分别为15.02±9.86分和20.15±10.02分)较对照组(26.18±11.26分)均有显著改善,而全身亚低温治疗组较局部亚低温治疗组亦有显著改善(P<0.01)。结论全身亚低温治疗及电子冰帽局部亚低温治疗均能促进高血压脑出血患者血肿周围水肿的消退,改善临床神经功能缺损。而全身亚低温还有减小血肿范围的作用,其促进血肿周围水肿的消退,改善临床神经功能缺损的作用要优于头颅局部亚低温治疗。更多还原

【Abstract】 Objective To compare the clinical effectives of systemic and selective mild hypothermic (MHT) treatment on patients with hypertensive intracerebral hemorrhage(HIH).Methods 96 cases with HIH were randomly divided into systemic MHT treatment group (30 cases),selective MHT treatment group (36 cases) and control group (30 cases).Routine treatment was used in the three groups,and the systemic treatment(electric-ice blanket) and selective MHT treatment (electric-ice cap) were used in systemic MHT treatment group and selective MHT,treatment group respectively.The volumes of hematoma and perihematoma edema measure by CT and the neurological defi- ciency score (NDS) and were assessed separately.Results The volumes of hematoma and the volume of perihematoma edema and NDS in the systemic MHT treatment group,selective MHT treatment group and control group all had no significant differences (P>0.01) seven days after therapy.While 14 days after therapy the volume of hematoma from systemic MHT treatment group(14.22±14.06 ml) was smaller than both the selective MHT group (20.64±16.41 ml) and control group (22.26±13.2 ml),apparently smaller remarkably (P<0.05);the size of perihematoma edema of systemic mild hypothermia (16.25±12.31ml) and selective mitcl hypothermia group(22.01±12.08 ml) both were smaller then the perihematoma edema(28.21±10.02 ml).(P<0.01).The systerrsc MHT group,in therapy effect,was better than selective MHT(P<0.01).The NDS score appeared systemic MHT(15.02±9.86 points)and selective MHT group (20.15±10.02 points) better than control group(28.18±11.26 points).Conclusion Systemic MHT and salective MHT could improved the perihemato- ma edema of hypertensive intracerebral hemorrhage and improve the function of NDS.The comparative effect of sqstenuic MHT was better than selective MHT.更多还原