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血液滤过亚低温治疗急性脑卒中新方法探讨

Hypothermia hemofiltration in treatment of acute cerebral stroke

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【作者】 凌斌孙洁白毅民李冰沁顾云帆刘萍陈晓雷吴志群

【Author】 LING Bin,SUN Jie,BAI Yi min,et al. Department of ICU,the Second People′s Hospital of Yunnan,Kunming 650021,China

【机构】 云南省第二人民医院ICU云南省第二人民医院ICU 云南昆明650021云南昆明650021云南昆明650021

【摘要】 目的 寻找一种快速的亚低温降温方法 ,为治疗急性脑卒中辟出新路。方法  76例急性脑卒中患者随机分为两组 ,亚低温血液滤过治疗组 (A组 ) 38例及常规亚低温治疗组 (B组 ) 38例 ,观察两组患者直肠温度降至 33℃的降温速率、降温时间、治疗前后格拉斯哥昏迷分级评分 (Glasgowcomascale,GCS)及神经功能缺损评分。 结果 A组降温速率较B组高 (P <0 .0 0 1) ,降温时间较B组短 (P <0 .0 0 1) ,治疗 15天及治疗 30天A组明显改善GCS评分 (P <0 .0 5~ 0 .0 1)、明显减低神经功能缺损评分 (P <0 .0 5~ 0 .0 0 1)。结论 血液滤过亚低温治疗急性脑卒中可明显缩短降温时间 ,相对延长亚低温治疗时间窗 ,扩大亚低温脑保护的治疗范围 ,充分保护脑组织 ,改善预后

【Abstract】 Objective To find a quicker and better means of hypothermia for better treatment effect.Methods 76 patients with acute cerebral stroke were randomly allocated to two groups,in group A(n=38)routine hypothermia with arteriovenous hemofiltration was applied,in group B (n=38) only routine hypothermia was given.The different lengths of time needed for hypothermia to 33℃ in the rectum were observed and their Glasgow coma scale (GCS) and neurologic deficit scores compared.Results In group A hypothermia took significantly less time than that in group B (P< ] 0.001 ).The average time taken for hypothermia in Group A was 57.1 minutes less than that taken in group B.Moreover,GCS scores in Group A were significantly higher than in Group B (P< 0.05 - 0.01 ),while neurologic deficit scores were significantly lower than in Group B ( P < 0.05 - 0.001 ).Conclusion Hemofiltration can definitely shorten the time to reach the target temperature in moderate hypothermia therapy,raising the effect of treatment of moderate hypothermia and improving the prognosis.

【关键词】 低温血液过滤脑血管意外
【Key words】 hypothermiahemofiltrationcerebrovascular disorders
  • 【文献出处】 临床荟萃 ,Clinical Focus , 编辑部邮箱 ,2003年13期
  • 【分类号】R743.3
  • 【被引频次】16
  • 【下载频次】81
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