浙江创伤外科
浙江創傷外科
절강창상외과
Zhejiang Journal of Traumatic Surgery
2015年
5期
847-848,852
,共3页
亚低温%弥漫性轴索损伤
亞低溫%瀰漫性軸索損傷
아저온%미만성축색손상
Mild Hypothermia%Diffuse axonal injury
目的 比较采用静脉灌注法血管内降温与降温毯体表降温达到亚低温治疗对重型弥漫性轴索损伤(DAI)患者凝血功能、内环境及预后的影响. 方法 前瞻性研究,35例符合入选标准的重型DAI患者,随机分为血管内降温组和降温毯组.分别比较两组患者达到亚低温目标温度的时间和治疗期间凝血功能障碍及内环境紊乱发生率,按照格拉斯哥转归量表进行预后评估. 结果 血管内降温组达到目标温度时间显著短于降温毯组,肌颤发生率更低;两组凝血功能障碍发生率、低血钾发生率、28天死亡率及预后改善无统计学差异. 结论 采用血管内降温与降温毯体表降温达到亚低温治疗对重型DAI患者凝血功能、内环境及预后影响无统计学差异,血管内降温达到目标温度时间更短,肌颤发生率低且轻微.
目的 比較採用靜脈灌註法血管內降溫與降溫毯體錶降溫達到亞低溫治療對重型瀰漫性軸索損傷(DAI)患者凝血功能、內環境及預後的影響. 方法 前瞻性研究,35例符閤入選標準的重型DAI患者,隨機分為血管內降溫組和降溫毯組.分彆比較兩組患者達到亞低溫目標溫度的時間和治療期間凝血功能障礙及內環境紊亂髮生率,按照格拉斯哥轉歸量錶進行預後評估. 結果 血管內降溫組達到目標溫度時間顯著短于降溫毯組,肌顫髮生率更低;兩組凝血功能障礙髮生率、低血鉀髮生率、28天死亡率及預後改善無統計學差異. 結論 採用血管內降溫與降溫毯體錶降溫達到亞低溫治療對重型DAI患者凝血功能、內環境及預後影響無統計學差異,血管內降溫達到目標溫度時間更短,肌顫髮生率低且輕微.
목적 비교채용정맥관주법혈관내강온여강온담체표강온체도아저온치료대중형미만성축색손상(DAI)환자응혈공능、내배경급예후적영향. 방법 전첨성연구,35례부합입선표준적중형DAI환자,수궤분위혈관내강온조화강온담조.분별비교량조환자체도아저온목표온도적시간화치료기간응혈공능장애급내배경문란발생솔,안조격랍사가전귀량표진행예후평고. 결과 혈관내강온조체도목표온도시간현저단우강온담조,기전발생솔경저;량조응혈공능장애발생솔、저혈갑발생솔、28천사망솔급예후개선무통계학차이. 결론 채용혈관내강온여강온담체표강온체도아저온치료대중형DAI환자응혈공능、내배경급예후영향무통계학차이,혈관내강온체도목표온도시간경단,기전발생솔저차경미.
Objective To compare the effect of two mild hypothermia therapy, cooling by intravenous vascular perfusion and cooling blankets, in patients with severe diffuse axonal injury (DAI). Methods 35 patients adapted the criteria of severe DAI were included. All patients were randomly di-vided into group of intravenous vascular perfusion cooling and the group of cooling blanket. All patients were investigated from the admission of intensive care unit to hospital discharge or death. In two groups of patients, the duration of reaching target temperature (35℃), the incidence rate of coagulopathy and inter-nal environment disorder were recorded. Glasgow Scale was used for the evaluation of prognostic outcome. Results Age, gender, pre-treatment GCS score, APACHEⅡscore had no statistically different in the two groups. The duration of reaching target temperature(35℃) in the group of intravenous vascu-lar perfusion cooling was significantly shorter than in cooling blanket group, which had the lower incidence rate of muscle trembling. There were no signifi-cant difference in coagulopathy incidence and the incidence of hypokalemia. 28 days mortality and the prognosis also had no significant difference. Con-clusion There were no significant difference in coagulation, internal environment and prognosis by using the two different mild hypothermia therapy, but intravenous vascular perfusion cooling could reach mild hypothermia more quickly, and had low incidence of muscle trembling.
