中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
19期
2883-2885
,共3页
脑损伤%低温,人工%自由基%预后
腦損傷%低溫,人工%自由基%預後
뇌손상%저온,인공%자유기%예후
Brain injuries%Hypothermia,induced%Free radicals%Prognosis
目的 探讨院前亚低温治疗对重型颅脑损伤患者的临床疗效,并通过患者血清氧自由基丙二醛(MDA)的变化探讨可能机制.方法 120例重型颅脑损伤患者按随机数字表法分为院前亚低温组(A组,65例)和对照组(B组,55例).A组院前即给予亚低温治疗,而B组仅在入院后给予亚低温治疗.比较两组入院时、第7天及第14天血清MDA变化,采用GOS评分比较6个月后疗效.结果 两组第7、14天的MDA水平[A组(10.4±1.5) nmol/L、(8.2±1.2) nmol/L,B组(12.6±1.9)nmol/L、(10.0±1.4)nmol/L]均高于入院时[A组(6.9±1.1)nmol/L,B组(6.6±1.0)nmol/L],以第7天时最高,且A组在第7、14天时均明显低于B组(t=2.337、2.512,均P＜0.05)；A组患者预后良好率为47.7％(31例),高于B组的38.2％(21例),而病死率为12.1％(8例),低于B组的21.4％(12例),差异有统计学意义(Z=-2.132,P＜0.05).结论 院前亚低温治疗能改善重型颅脑损伤预后,减轻脑组织损伤.
目的 探討院前亞低溫治療對重型顱腦損傷患者的臨床療效,併通過患者血清氧自由基丙二醛(MDA)的變化探討可能機製.方法 120例重型顱腦損傷患者按隨機數字錶法分為院前亞低溫組(A組,65例)和對照組(B組,55例).A組院前即給予亞低溫治療,而B組僅在入院後給予亞低溫治療.比較兩組入院時、第7天及第14天血清MDA變化,採用GOS評分比較6箇月後療效.結果 兩組第7、14天的MDA水平[A組(10.4±1.5) nmol/L、(8.2±1.2) nmol/L,B組(12.6±1.9)nmol/L、(10.0±1.4)nmol/L]均高于入院時[A組(6.9±1.1)nmol/L,B組(6.6±1.0)nmol/L],以第7天時最高,且A組在第7、14天時均明顯低于B組(t=2.337、2.512,均P＜0.05)；A組患者預後良好率為47.7％(31例),高于B組的38.2％(21例),而病死率為12.1％(8例),低于B組的21.4％(12例),差異有統計學意義(Z=-2.132,P＜0.05).結論 院前亞低溫治療能改善重型顱腦損傷預後,減輕腦組織損傷.
목적 탐토원전아저온치료대중형로뇌손상환자적림상료효,병통과환자혈청양자유기병이철(MDA)적변화탐토가능궤제.방법 120례중형로뇌손상환자안수궤수자표법분위원전아저온조(A조,65례)화대조조(B조,55례).A조원전즉급여아저온치료,이B조부재입원후급여아저온치료.비교량조입원시、제7천급제14천혈청MDA변화,채용GOS평분비교6개월후료효.결과 량조제7、14천적MDA수평[A조(10.4±1.5) nmol/L、(8.2±1.2) nmol/L,B조(12.6±1.9)nmol/L、(10.0±1.4)nmol/L]균고우입원시[A조(6.9±1.1)nmol/L,B조(6.6±1.0)nmol/L],이제7천시최고,차A조재제7、14천시균명현저우B조(t=2.337、2.512,균P＜0.05)；A조환자예후량호솔위47.7％(31례),고우B조적38.2％(21례),이병사솔위12.1％(8례),저우B조적21.4％(12례),차이유통계학의의(Z=-2.132,P＜0.05).결론 원전아저온치료능개선중형로뇌손상예후,감경뇌조직손상.
Objective To investigate the clinical efficacy of pre-hospital mild hypothermia in patients with severe craniocerebral injury,and to explore the possible mechanism by the changes of serum Malondialdehyde (MDA).Methods 120 cases of severe craniocerebral injury were divided into pre-hospital mild hypothermia group (group A,65 cases) and control group(group B,55 cases) by random number table.Patients in group A were gave pre-hospital mild hypothermia treatment,and patients in group B were gave mild hypothermia therapy only after hospitalization.Comparison of the change of serum MDA at admission,the 7th and 14th day between two groups,and the functional outcomes were evaluated by GOS score in 6 months after treatment.Results The MDA levels of two group at seventh days and 14 days were higher than that at admission [(10.4 ± 1.5)nmol/L and (8.2 ± 1.2)nmol/L in group A,(12.6 ± 1.9)nmol/L and (10.0 ± 1.4)nmol/L in group B,P ＜0.05],and it was the highest at 7th day,and its in group A was significantly lower than that in group B at 7th,14th day [(6.9 ± 1.1) nmol/L in group A,(6.6 ±1.0) nmol/L in group B,P ＜ 0.05].The good prognosis rate was 47.7％ (31 cases) in group A,higher than the 38.2％ (21 cases) in group B;The mortality rate was 12.1％ (8 cases) in group A,lower than the 21.4％ (12 cases)the group B,and the difference was statistically significant (Z =-2.132,P ＜ 0.05).Conclusion Pre-hospital mild hypothermia treatment can improve the prognosis of patients with severe craniocerebral injury and alleviate the damage of brain tissues.
