摘要
目的研究亚低温对重型颅脑创伤（sTBI）合并急性创伤性凝血病（ATC）患者的影响及其临床意义。方法83例sTBI合并ATC患者随机分为亚低温治疗组42例、常规治疗组（对照组）41例。亚低温治疗组均于伤后24h内接受亚低温治疗。分别测量两组患者不同时间点的凝血酶原时间（PT）、部分凝血酶原时间（AFIT）、凝血时问（TT）、纤维蛋白原（FIB）及D-二聚体水平，同时监测患者颅内压（ICP）以及生命体征、血气、血电解质及动脉血氧饱和度等，并根据GOS评估法判断预后。结果亚低温治疗组患者PT、AFIT、Tr、FIB及D-二聚体与对照组相比差异无统计学意义（P〉0．05），而颅内压明显降低（P〈0．01）；生命体征、血气、血电解质、动脉血氧饱和度差异无统计学意义，无严重并发症，病死率低，预后改善明显。结论亚低温治疗不会增加sTBI合并ATC患者出现凝血障碍及纤溶亢进的风险，并且能有效地降低颅内压，具有肯定的脑保护作用，是一项安全有效的治疗措施。
Objective To study the effect of hypothermia and its clinical significance in patients with severe traumatic brain injury （sTBI） and acute traumatic coagulopathy （ATC）. Methods All 83 patients were randomly assigned into two groups ： the hypothermia group consisted of 42 patients with hypothennia treatment and the control group consisted of 41 cases with routine treatments. Hypothermia was induced within 24 hours after brain injury. The levels of PT, AF1T, TT, FIB, and D - dimer were measured. Meantime, intracranial pressure （ICP）, vital signs, blood gas values, blood electrolytes, and arterial oxygen saturation were also measured. Prognosis was evaluated according to the Glasgow Outcome Scale （GOS）. Results Compared to the control group, there were no significant differences between levels of PT, APIT, TI＇, FIB, and D-dimer （ P 〉0.05） and ICP significantly decreased （ P 〈0.01） respectively in the hypothermia group. The vital signs, blood gas values, blood electrolytes, and arterial oxygen saturation were not significantly changed. No severe complications were found. The mortality was lower and COS of the patients dischm-ge was improved in the hypothennia group than that of the control group. Conclusions In patients with sTBI and ATC, hypothermia will not increase the risk of coagnlopathy and hyperfibrinolysis; it can protect brain tissues through decreasing ICP, and it is a safe and effective therapy.
出处
《中华神经外科杂志》
CSCD
北大核心
2013年第2期142-145,共4页
Chinese Journal of Neurosurgery
基金
国家自然科学基金（31200809）
武警后勤学院附属医院重点项目（FYZ201201）
关键词
外伤性脑损伤
急性创伤性凝血病
亚低温
Traumatic brain injury
Acute traumatic coagulopatby
Hypotherrnia
