CAJ | 학술논문

目的：探讨亚低温对脑出血患者血清中谷氨酸水平的影响及治疗疗效。方法选取自2011年至2012年黑龙江省南岗医院神经外科收治的116例经头颅CT证实脑出血患者。将其按随机数字表法分成A、B两组，A组为亚低温治疗组，B组为常规治疗组，每组58例患者。A组给予亚低温冬眠疗法，使用国产HGT-200型亚低温治疗仪，在水箱中注入2500 ml蒸馏水及95%乙醇500 ml。B组给予常规脱水、营养神经治疗。用高效液相色谱法分析两组患者入院24 h和6 d血清中谷氨酸的含量，比较其临床疗效及并发症。血清谷氨酸含量组间比较用t检验，总有效率和并发症发生率组间比较用χ2检验，以P＜0.05为差异有统计学意义。结果 A组血清中谷氨酸含量在24 h和6 d分别低于B组，分别为24 h时(84.6±2.3)μmol/L和(104.6±3.2)μmol/L、6 d时(114.4±3.6)μmol/L和(190.3±4.7)μmol/L，差异具有统计学意义(t=31.269、67.413，P均<0.05)。A组总有效率84.48%(49/58)，死亡率8.62%(5/58)；B组总有效率48.27%(28/58)，死亡率36.21%(21/58)，两组相比较，差异有统计学意义(χ2=17.032、12.691，P＜0.01)。A组27例，B组28例发生并发症，总并发症各组比较差异无统计学意义(χ2=1.254，P＞0.05)。结论亚低温可以降低脑出血患者血清谷氨酸的含量，减轻脑损伤。对脑出血患者采取亚低温治疗，能提高治疗有效率。
목적：탐토아저온대뇌출혈환자혈청중곡안산수평적영향급치료료효。방법선취자2011년지2012년흑룡강성남강의원신경외과수치적116례경두로CT증실뇌출혈환자。장기안수궤수자표법분성A、B량조，A조위아저온치료조，B조위상규치료조，매조58례환자。A조급여아저온동면요법，사용국산HGT-200형아저온치료의，재수상중주입2500 ml증류수급95%을순500 ml。B조급여상규탈수、영양신경치료。용고효액상색보법분석량조환자입원24 h화6 d혈청중곡안산적함량，비교기림상료효급병발증。혈청곡안산함량조간비교용t검험，총유효솔화병발증발생솔조간비교용χ2검험，이P＜0.05위차이유통계학의의。결과 A조혈청중곡안산함량재24 h화6 d분별저우B조，분별위24 h시(84.6±2.3)μmol/L화(104.6±3.2)μmol/L、6 d시(114.4±3.6)μmol/L화(190.3±4.7)μmol/L，차이구유통계학의의(t=31.269、67.413，P균<0.05)。A조총유효솔84.48%(49/58)，사망솔8.62%(5/58)；B조총유효솔48.27%(28/58)，사망솔36.21%(21/58)，량조상비교，차이유통계학의의(χ2=17.032、12.691，P＜0.01)。A조27례，B조28례발생병발증，총병발증각조비교차이무통계학의의(χ2=1.254，P＞0.05)。결론아저온가이강저뇌출혈환자혈청곡안산적함량，감경뇌손상。대뇌출혈환자채취아저온치료，능제고치료유효솔。
Objective To study the effect of mild hypothermia on glutamic acid level in patient’ s blood serum after the cerebral hemorrhage. Methods We selected 116 cases of cerebral hemorrhage from 2011 to 2012 in the Department of Neurosurgery, Heilongjiang Provincal Hospital Nangang Branch, and confirmed by head CT. We divided the cases into group A (mild hypothermia treatment) and group B (conventional treatment), each group have 58 patients. Mild hypothermia treatment with domestic HGT-200 mild hypothermia therapeutic instrument were applied to the patients in group A, the tank was injected into 2 500 ml distilled water and 500 ml 95% ethanol. Only conventional treatment (trophic nerve and routine dehydration) was applied to the patients in group B. The glutamic acid level in 24 h and 6 d after admission was analyzed in patient's blood serum by the high performance liquid chromatography to compare the situation of clinical outcomes and complications. Serum glutamic acid level among groups was tested by t test, the total effective rate and the incidence of complications among groups was tested byχ2 test. Results The level of glutamic acid in group A was lower than that in group B at both time point of 24 h(84.6 ± 2.6μmol/L vs 114.4 ± 3.6μmol/L, t=31.269, P<0.05) and 6 d(104.6 ± 3.2μmol/L vs 190.3 ± 4.7μmol/L, t=37.413, P<0.05).The total effective rate of group A was 84.48% (49/58), mortality of group A was 8.62% (5/58), the total effective rate of group B was 48.27% (28/58), mortality of group B was 36.21% (21/58), the difference on both total effective rate and mortality among groups are significant (χ2=17.032、12.691, P<0.01). Complications, 27 cases in group A and 28 cases in group B, and there was no statistical significance of difference among groups (χ2=1.254, P>0.05). Conclusions Mild hypothermia treatment may be an effective method to degrade the level of glutamic acid in patient's blood serum and alleviate brain injuries. The mild hypothermia therapy may improve outcomes of patients.