CAJ | 학술논문

目的：通过比较亚低温处理以及常规处理对重型颅脑损伤(sTBI)合并急性创伤性凝血病(ATC)患者的临床治疗效果，研究亚低温处理对sTBI合并ATC的临床应用价值。方法：选取sTBI合并ATC患者100例，随机分为实验组和对照组，实验组患者采取亚低温处理，对照组患者采取常规处理。测量实验组和对照组患者在不同阶段的血浆纤维蛋白原(FIB)、血浆凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及D-二聚体(D-D)水平，同时对患者的生命体征、血氧饱和度、血电解质、血气、颅内压及并发症情况进行检测记录。结果：经亚低温处理后实验组患者的FIB、TT、APTT、PT、D-D水平以及生命体征、血氧饱和度、血电解质及血气指标等与对照组患者无显著差异；但实验组患者的颅内压治疗1d、3d和5d后均显著低于对照组，其差异有统计学意义(t=4.76，t=9.87，t=8.92；P＜0.01)。结论：sTBI合并ATC患者采用亚低温处理与常规处理相比不会带来风险，而且还能显著降低患者的颅内压，对患者脑组织起到保护作用。
목적：통과비교아저온처리이급상규처리대중형로뇌손상(sTBI)합병급성창상성응혈병(ATC)환자적림상치료효과，연구아저온처리대sTBI합병ATC적림상응용개치。방법：선취sTBI합병ATC환자100례，수궤분위실험조화대조조，실험조환자채취아저온처리，대조조환자채취상규처리。측량실험조화대조조환자재불동계단적혈장섬유단백원(FIB)、혈장응혈매시간(TT)、활화부분응혈활매시간(APTT)、응혈매원시간(PT)급D-이취체(D-D)수평，동시대환자적생명체정、혈양포화도、혈전해질、혈기、로내압급병발증정황진행검측기록。결과：경아저온처리후실험조환자적FIB、TT、APTT、PT、D-D수평이급생명체정、혈양포화도、혈전해질급혈기지표등여대조조환자무현저차이；단실험조환자적로내압치료1d、3d화5d후균현저저우대조조，기차이유통계학의의(t=4.76，t=9.87，t=8.92；P＜0.01)。결론：sTBI합병ATC환자채용아저온처리여상규처리상비불회대래풍험，이차환능현저강저환자적로내압，대환자뇌조직기도보호작용。
Objective:To compare hypothermia treatment and conventional treatment for severe traumatic brain injury patients with acute traumatic coagulopathy the clinical therapeutic effect of hypothermia treatment to explore the clinical value.Methods: A hospital sTBI merger ATC 100 patients were randomly divided into experimental and control groups, the experimental group were taken hypothermia treatment in the control group of patients taking conventional treatment. Measuring experimental group and control group of patients at different stages of FIB, TT, APTT, PT, and D-dimer levels, while the patient's vital signs, oxygen saturation, blood electrolytes, blood pressure, intracranial pressure and complications testing records.Results: The results showed that the experimental group were FIB, TT, APTT, PT, D-dimer levels and vital signs, oxygen saturation, serum electrolytes, blood gas analysis and other patients with no significant difference between the control group; However, the experimental group of patients with intracranial pressure was significantly lower than the control group(t=4.76,t=9.87,t=8.92;P<0.01).Conclusion: sTBI combined use of mild hypothermia treatment in patients with ATC compared to conventional treatment does not pose a risk, but it also significantly lower in patients with intracranial pressure, brain tissue of the patient play a protective role.