【摘要】 目的:探讨分析不同温度梯度的亚低温治疗对颅脑损伤患者的临床疗效及预后的影响。方法:选取2022年6月—2024年7月东莞市厚街医院重症医学科收治的60例重型颅脑损伤患者均给予亚低温治疗，分为较低梯度组(32～33.9℃)30例、较高梯度组(34～35.9℃)30例，比较两组患者临床疗效，7天、28天死亡率及ICU住院时间，治疗前、治疗48h后颅内压及脑血流，治疗前、治疗60天后GCS评分，随访3个月比较两组并发症。结果:较高梯度组临床疗效预后满意率为76.67%,显著高于较低梯度组(56.67%),差异具有统计学意义(P<0.05)。较高梯度组7天、28天死亡率均显著低于较低梯度组(0.00%VS 13.00%、3.33%VS 23.33%);ICU住院时间为(7.85±1.36)天，显著短于较低梯度组的(9.92±1.40)天，差异具有统计学意义(P<0.05)。治疗前两组颅内压及脑血流指标(血流动态阻力、平均血流流速、脑氧摄取量、搏动波速、脑部平均血流量)无显著性差异(P>0.05),治疗48h后两组颅内压及脑血流指标均显著改善，且治疗48h后较高梯度组颅内压及脑血流指标较低梯度组改善更显著(P<0.05)。治疗前两组GCS评分无显著性差异(P>0.05),治疗60天后两组GCS评分均显著提高，且治疗60天后较高梯度组GCS评分显著高于较低梯度组(P<0.05)。较高梯度组并发症发生率为10.00%,显著低于较低梯度组(30.00%),差异具有统计学意义(P<0.05)。结论:较高梯度(34～35.9℃)亚低温治疗颅脑损伤患者可提高临床疗效，降低颅内压，改善脑血流功能，降低死亡率，减少并发症发生，改善患者预后。更多还原

【Abstract】 Objective:To investigate the effect of mild hypothermia with different temperature gradients on the clinical efficacy and prognosis of patients with craniocerebral injury. Methods:A total of 60 patients with severe craniocerebral injury admitted to the Department of Critical Care Medicine of Dongguan Houjie Hospital from June 2022 to July 2024 were selected and treated with mild hypothermia. They were divided into low gradient group(32～33.9℃) and high gradient group(34～35.9℃). The clinical efficacy, 7-day mortality and ICU stay time of the two groups were compared. Intracranial pressure and cerebral blood flow before and 48 hours after treatment, GCS score before and 60 days after treatment, complications. Results:The satisfaction rate of clinical efficacy and prognosis in the higher gradient group was 76.67%, which was significantly higher than that in the lower gradient group(56.67%)(P<0.05). The mortality rate at 7 and 28 days in the higher gradient group was significantly lower than that in the lower gradient group(20.00% VS 13.00%、3.33% VS 23.33%). The length of ICU stay(7.85±1.36) d was significantly lower than that of the lower gradient group(9.92±1.40) d(P<0.05), and there were no significant differences in intracranial pressure and cerebral blood flow indexes(dynamic blood flow resistance, average blood flow velocity, cerebral oxygen intake, pulse velocity, and average cerebral blood flow) between the two groups before treatment(P>0.05). Intracranial pressure and cerebral blood flow indexes of both groups were significantly improved after 48h of treatment, and the higher gradient group was more significantly improved after 48h of treatment(P<0.05), there was no significant difference in GCS scores between the two groups before treatment(P>0.05), and GCS scores of both groups were significantly improved after 60 days of treatment. After 60 days of treatment, the GCS score of the higher gradient group was significantly higher than that of the lower gradient group(P<0.05), and the complication rate of the higher gradient group(10.00%) was significantly lower than that of the lower gradient group(30.00%)(P<0.05). Conclusion:Mild hypothermia with higher gradient(34～35.9℃) can improve clinical efficacy, reduce intracranial pressure, improve cerebral blood flow function, reduce mortality, reduce complications and improve the prognosis of patients with craniocerebral injury.更多还原