控制体温联合过度通气治疗重型颅脑损伤的对比研究

【摘要】 目的探讨在开颅减压性手术治疗的基础上,采用控制体温(35~36℃)联合中度过度通气(PaCO230~34 mmHg)治疗重型颅脑损伤的疗效与预后。方法 61例重型颅脑损伤随机分成控制体温联合中度过度通气疗法组(治疗组)30例与常规治疗法组(对照组)31例,通过与采取常规治疗的对照组进行对比研究,以观察采取控制体温(35~36℃)联合中度过度通气(PaCO230~34 mmHg)治疗重型颅脑损伤的疗效及预后。结果控制体温(35~36℃)联合中度过度通气(PaCO2在30~34 mmHg)组(治疗组)治疗重型颅脑损伤病死率低于常规治疗组(对照组)(P<0.05),而恢复良好率显著高于对照组(P<0.05);治疗组与对照组并发症总发生率对比差异无显著性。结论控制体温联合过度通气治疗对急性重型颅脑损伤患者,特别是对术后伴有严重脑水肿,中、重度颅内高压和顽固性中枢性高热的重型患者能明显减少病死率,且操作简单,体温及呼吸机辅助呼吸易控制,技术要求不高,并发症少,尤其适合于基层医院开展,是目前治疗重型颅脑损伤安全有效的方法。更多还原

【Abstract】 Objective Investigate the cranial decompression surgery treatment on the basis of the control of body temperature joint moderate hyperventilation the efficacy of the treatment of severe traumatic brain injury and prognosis of.Methods 61 patients with severe head injury were randomly divided into a control body temperature joint moderate hyperventilation therapy group(treatment group) with conventional therapy group(control group),compared with the control group taking conventional treatment,to take control body temperature was observed 35-36℃ combined with moderate hyperventilation(PaCO 2 30-34 mmHg) the efficacy of the treatment of severe traumatic brain injury and prognosis.Results Control of body temperature Joint moderate hyperventilation(treatment group) treatment of severe traumatic brain injury have lower mortality rates than conventional treatment group(control group),and good recovery rate significantly higher than that of the control group; treatment The total incidence of complications with the control group no significant difference in contrast.Conclusion Joint control body temperature hyperventilation treatment of patients with acute severe traumatic brain injury,especially on postoperative with severe cerebral edema,severe intracranial hypertension refractory central high fever,severe patients can significantly reduce the mortality rate,and the operation is simple,easy to control body temperature and mechanical ventilation,technically less demanding,less complications,especially suitable for the primary hospital is currently safe and effective treatment of severe traumatic brain injury.更多还原