CAJ | 학술논문

目的：比较亚低温与常温治疗重型颅脑损伤患者的临床效果。方法：选取入住ICU病区的重型颅脑损伤患者72例，随机分为亚低温组( n＝36)接受32~35℃低温治疗，对照组( n＝36)体温维持在(37±0.5)℃，观察其临床疗效。结果：随访6个月，对照组死亡13人，植物状态2人，重度残疾4人，轻度残疾7人，良好康复10人，亚低温治疗组死亡5人，植物状态1人，重度残疾2人，轻度残疾13人，良好康复15人，亚低温治疗组伤后6个月死亡率较对照组降低(χ2＝4.471，P＝0.029)，且良好神经系统转归明显高于对照组(χ2＝7.170，P＝0.007)。亚低温治疗组血清中S-100B蛋白含量在治疗后3~7 d低于对照组，差异有统计学意义(P<0.05)。结论：在常规治疗基础上联合亚低温治疗对重型颅脑损伤患者具有脑保护作用并能降低死残率。
목적：비교아저온여상온치료중형로뇌손상환자적림상효과。방법：선취입주ICU병구적중형로뇌손상환자72례，수궤분위아저온조( n＝36)접수32~35℃저온치료，대조조( n＝36)체온유지재(37±0.5)℃，관찰기림상료효。결과：수방6개월，대조조사망13인，식물상태2인，중도잔질4인，경도잔질7인，량호강복10인，아저온치료조사망5인，식물상태1인，중도잔질2인，경도잔질13인，량호강복15인，아저온치료조상후6개월사망솔교대조조강저(χ2＝4.471，P＝0.029)，차량호신경계통전귀명현고우대조조(χ2＝7.170，P＝0.007)。아저온치료조혈청중S-100B단백함량재치료후3~7 d저우대조조，차이유통계학의의(P<0.05)。결론：재상규치료기출상연합아저온치료대중형로뇌손상환자구유뇌보호작용병능강저사잔솔。
Objective:To compare the effects of mild hypothermia and normothermia on the outcomes in patients with severe traumatic brain injury. Methods: Seventy-two patients with severe traumatic brain injury admitted to Intensive Care Unit were randomly assigned to mild hypothermia (32~35℃) group (n=36),and normothermia (37 ± 0. 5)℃ group (n =36), which allowed the assessment of the therapeutic outcomes. Results:At month 6 during follow-up period, 13 cases succumbed, 2 were persistently vegetative, 4 severely disabled, 7 mildly disabled and 10 recovered in normothermia group, whilst these figures were 5,1, 2, 13 and 15 in mild hypothermia group. The mild hypothermia group was associated with a reduced mortality and a higher rate of acceptable neurologic function at month 6 after injury (χ2 =4. 471, P=0. 029;χ2 =7. 170, P=0. 007). Additionally, mild hypothermia led to markedly lower levels of serum S-100B protein following the treatment for 3 to 7 days ( P < 0. 05 ). Conclusion: Mild hypothermia has, on the basis of conventional treatment, neuroprotective effects and reduce the mortality rate in patients with severe traumatic brain injury.