【摘要】 目的探讨亚低温对脑出血患者血清中谷氨酸水平的影响及治疗疗效。方法选取自2011年至2012年黑龙江省南岗医院神经外科收治的116例经头颅CT证实脑出血患者。将其按随机数字表法分成A、B两组,A组为亚低温治疗组,B组为常规治疗组,每组58例患者。A组给予亚低温冬眠疗法,使用国产HGT-200型亚低温治疗仪,在水箱中注入2 500 ml蒸馏水及95%乙醇500 ml。B组给予常规脱水、营养神经治疗。用高效液相色谱法分析两组患者入院24 h和6 d血清中谷氨酸的含量,比较其临床疗效及并发症。血清谷氨酸含量组间比较用t检验,总有效率和并发症发生率组间比较用χ~2检验,以P<0.05为差异有统计学意义。结果 A组血清中谷氨酸含量在24 h和6 d分别低于B组,分别为24 h时(84.6±2.3)μmol/L和(104.6±3.2)μmol/L、6 d时(114.4±3.6)μmol/L和(190.3±4.7)μmol/L,差异具有统计学意义(t=31.269、67.413,P均<0.05)。A组总有效率84.48%(49/58),死亡率8.62%(5/58);B组总有效率48.27%(28/58),死亡率36.21%(21/58),两组相比较,差异有统计学意义(χ~2=17.032、12.691,P<0.01)。A组27例,B组28例发生并发症,总并发症各组比较差异无统计学意义(χ~2=1.254,P>0.05)。结论亚低温可以降低脑出血患者血清谷氨酸的含量,减轻脑损伤。对脑出血患者采取亚低温治疗,能提高治疗有效率。更多还原

【Abstract】 Objective To study the effect of mild hypothermia on glutamic acid level in patient’ s blood serum after the cerebral hemorrhage. Methods We selected 116 cases of cerebral hemorrhage from 2011 to 2012 in the Department of Neurosurgery, Heilongjiang Provincal Hospital Nangang Branch, and confirmed by head CT. We divided the cases into group A(mild hypothermia treatment) and group B(conventional treatment), each group have 58 patients. Mild hypothermia treatment with domestic HGT-200 mild hypothermia therapeutic instrument were applied to the patients in group A, the tank was injected into 2 500 ml distilled water and 500 ml 95% ethanol. Only conventional treatment(trophic nerve and routine dehydration) was applied to the patients in group B.The glutamic acid level in 24 h and 6 d after admission was analyzed in patient’s blood serum by the high performance liquid chromatography to compare the situation of clinical outcomes and complications. Serum glutamic acid level among groups was tested by t test, the total effective rate and the incidence of complications among groups was tested by χ2test. Results The level of glutamic acid in group A was lower than that in group B at both time point of 24 h(84.6±2.6μmol/L vs 114.4±3.6μmol/L, t=31.269, P<0.05) and 6 d(104.6 ± 3.2μmol/L vs 190.3 ± 4.7μmol/L, t=37.413, P<0.05).The total effective rate of group A was 84.48%(49/58), mortality of group A was 8.62%(5/58), the total effective rate of group B was 48.27%(28/58), mortality of group B was 36.21%(21/58), the difference on both total effective rate and mortality among groups are significant(χ~2=17.032、12.691,P<0.01). Complications, 27 cases in group A and 28 cases in group B, and there was no statistical significance of difference among groups(χ~2=1.254, P>0.05). Conclusions Mild hypothermia treatment may be an effective method to degrade the level of glutamic acid in patient’s blood serum and alleviate brain injuries. The mild hypothermia therapy may improve outcomes of patients.更多还原