【摘要】 目的探讨亚低温对儿童外伤性脑损伤(traumatic brain injury,TBI)的脑保护作用,并评价其临床安全性。方法将22例重症TBI患儿随机分为亚低温治疗组(颅温(34.5±0.2)℃,持续72h;n=12)和常温对照组(不进行降温治疗;n=10)。检测脑脊液中特异性烯醇化酶(NSE)、S-100蛋白(S-100)、磷酸肌酸激酶脑型同工酶(CK-BB)的变化,监测颅内压及生命体征、酸碱平衡、血电解质水平。结果常温对照组伤后48h颅内压达高峰,平均为(26.2±8.7)mmHg,亚低温治疗组颅内压均维持在较低水平,各时点指标较常温对照组均明显降低(P<0.01);亚低温治疗组脑脊液S-100、CK-BB测定值明显低于常温对照组各时点水平(P<0.05、P<0.001);两组生命体征稳定,血酸碱平衡,血电解质正常,亚低温组心率较常温组降低(P<0.05)。结论亚低温对儿童严重TBI具有较好的脑保护作用,颅温34.5℃左右,持续72h在临床上是安全的。更多还原

【Abstract】 Objective To investigate the safety and neuroprotection of moderate hypothermia in children with traumatic brain injury (TBI). Methods The TBI children were divided randomly into the moderate hypothermia group (intracranial temperature 34.5℃±0.2℃, keeping on 72 h, n = 12) and the control group ( n = 10). The cerebrospinal fluid (CSF) NSE, S- 100, CK- BB levels, intracranial pressure (ICP) levels were used to assess the protective effects.The variety of the sour alkali balance, electrolyte were inspected. Results The peak levels of ICP in control group (26.2±8.7 mmHg ) was reached in 48h after TBI. The ICP levels in moderate hypothermia group were lower than those in control group at each hour sign (P < 0.01). At 24 h, 48 h, 72 h, the NSE, S- 100, CK- BB levels in moderate hypothermia group were also lower than those in control group (P < 0.01). In two groups the sour alkali balance and the electrolyte is normal. In moderate hypothermia group the heart rate were lower than that in control group (P < 0.05). Conclusions Moderate hypothermia has the better brain protection function to children’s severity TBI. Keeping the intracranial temperature at 34.5℃, persisting 72 hours is safe on the clinic.更多还原