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目的探讨重症颅脑伤患者亚低温治疗期间的温度控制及其临床意义。方法对62例重型颅脑伤患者进行选择性脑亚低温治疗,温度设定为33℃～35℃;同时持续静脉滴注冬眠肌松剂,给予呼吸机辅助呼吸。冬眠肌松剂成分:500ml生理盐水+氯丙嗪100mg+异丙嗪100mg+卡肌宁200～400mg。经4～12h患者脑温降至33℃～35℃,维持2～10d。采用自然复温,患者经10～12h恢复正常体温。结果本组存活38例(61.29%),死亡14例(38.71%),38例存活者中治愈30例,好转5例,植物状态3例。结论亚低温治疗是重症颅脑伤患者重要治疗方法之一,能显著减轻脑损伤后神经功能障碍和脑病理形态损害,保护血脑屏障功能,从而明显降低重型颅脑伤患者的病死率,改善预后。
Objective To investigate the temperature control and its clinical significance during mild hypothermia in patients with severe craniocerebral injury. Methods Sixty-two patients with severe craniocerebral injury were treated with selective cerebral mild hypothermia, and the temperature was set between 33 ℃ and 35 ℃. Simultaneously, hibernating muscle relaxants were continuously administered intravenously and the ventilator assisted breathing. Hibernating muscle relaxants Ingredients: 500ml saline + chlorpromazine 100mg + promethazine 100mg + card muscle Ning 200 ~ 400mg. After 4 ~ 12h patients brain temperature dropped to 33 ℃ ~ 35 ℃, maintained 2 ~ 10d. Natural rewarming, the patient by 10 ~ 12h to restore normal body temperature. Results In this group, 38 cases (61.29%) survived and 14 (38.71%) died. Among 38 survivors, 30 cases were cured, 5 cases improved, and 3 cases were plant. Conclusion Mild hypothermia treatment is one of the most important treatments for severe craniocerebral injury patients. It can significantly reduce neurological dysfunction and damage of brain pathology after brain injury and protect the function of blood-brain barrier, thus significantly reducing the mortality and improving the prognosis of patients with severe craniocerebral injury.