CAJ | 학술논문

目的：探讨在开颅减压性手术治疗的基础上，采用控制体温（35～36℃）联合中度过度通气(PaCO 230～34 mmHg)治疗重型颅脑损伤的疗效与预后。方法61例重型颅脑损伤随机分成控制体温联合中度过度通气疗法组(治疗组)30例与常规治疗法组(对照组)31例，通过与采取常规治疗的对照组进行对比研究，以观察采取控制体温（35～36℃）联合中度过度通气(PaCO 230～34 mmHg)治疗重型颅脑损伤的疗效及预后。结果控制体温（35～36℃）联合中度过度通气（PaCO 2在30～34 mmHg）组（治疗组）治疗重型颅脑损伤病死率低于常规治疗组（对照组）（P＜0.05），而恢复良好率显著高于对照组（P＜0.05）；治疗组与对照组并发症总发生率对比差异无显著性。结论控制体温联合过度通气治疗对急性重型颅脑损伤患者，特别是对术后伴有严重脑水肿，中、重度颅内高压和顽固性中枢性高热的重型患者能明显减少病死率，且操作简单，体温及呼吸机辅助呼吸易控制，技术要求不高，并发症少，尤其适合于基层医院开展，是目前治疗重型颅脑损伤安全有效的方法。
목적：탐토재개로감압성수술치료적기출상，채용공제체온（35～36℃）연합중도과도통기(PaCO 230～34 mmHg)치료중형로뇌손상적료효여예후。방법61례중형로뇌손상수궤분성공제체온연합중도과도통기요법조(치료조)30례여상규치요법조(대조조)31례，통과여채취상규치료적대조조진행대비연구，이관찰채취공제체온（35～36℃）연합중도과도통기(PaCO 230～34 mmHg)치료중형로뇌손상적료효급예후。결과공제체온（35～36℃）연합중도과도통기（PaCO 2재30～34 mmHg）조（치료조）치료중형로뇌손상병사솔저우상규치료조（대조조）（P＜0.05），이회복량호솔현저고우대조조（P＜0.05）；치료조여대조조병발증총발생솔대비차이무현저성。결론공제체온연합과도통기치료대급성중형로뇌손상환자，특별시대술후반유엄중뇌수종，중、중도로내고압화완고성중추성고열적중형환자능명현감소병사솔，차조작간단，체온급호흡궤보조호흡역공제，기술요구불고，병발증소，우기괄합우기층의원개전，시목전치료중형로뇌손상안전유효적방법。
Objective Investigate the cranial decompression surgery treatment on the basis of the control of body temperature joint moderate hyperventilation the efifcacy of the treatment of severe traumatic brain injury and prognosis of.Methods 61 patients with severe head injury were randomly divided into a control body temperature joint moderate hyperventilation therapy group (treatment group) with conventional therapy group (control group), compared with the control group taking conventional treatment, to take control body temperature was observed 35-36℃combined with moderate hyperventilation (PaCO 2 30-34 mmHg) the efifcacy of the treatment of severe traumatic brain injury and prognosis. Results Control of body temperature Joint moderate hyperventilation (treatment group) treatment of severe traumatic brain injury have lower mortality rates than conventional treatment group (control group), and good recovery rate signiifcantly higher than that of the control group;treatment The total incidence of complications with the control group no signiifcant difference in contrast.Conclusion Joint control body temperature hyperventilation treatment of patients with acute severe traumatic brain injury, especially on postoperative with severe cerebral edema, severe intracranial hypertension refractory central high fever, severe patients can significantly reduce the mortality rate, and the operation is simple, easy to control body temperature and mechanical ventilation, technically less demanding, less complications, especially suitable for the primary hospital is currently safe and effective treatment of severe traumatic brain injury.