目的 探讨低温治疗对重型颅脑损伤患者血浆内皮素-1的影响。方法 回顾性分析武警山东总队医院神经重症单元2015-06至2020-06收治的52例神经外科重症(脑外伤)患者临床资料,常规治疗的26例作为对照组,常规治疗结合低温治疗的26例作为观察组。比较两组患者治疗过程中血浆内皮素-1及颅内压监测数值,比较同一时期两组格拉斯哥预后评分(GOS)和日常生活能力评分(ADL)。结果 治疗后观察组第3、5、7、14天血浆内皮素-1值[(124.6±10.2)、(91.7±8.4)、(66.2±5.5)、(45.4±4.6)ng/L],均低于对照组[(130.4±8.7)、(99.6±10.6)、(72. 8±9.8)、(52.0±6.8)ng/L],差异均有统计学意义(P＜0.05)。治疗后观察组第3、5、7、14天颅内压[(18.0±3.2)、(15.5±4.3)、(14.5±3.2)、(13.0±3.5)mmHg],均低于对照组[(19.8±4.0)、(18.4±4.6)、(17. 5±3.7)、(16.2±3.7)mmHg],差异均有统计学意义(P＜0.05)。伤后3个月GOS评分,观察组为(4.12±0.99)分,对照组为(3.54±1.07)分,观察组高于对照组,差异具有统计学意义(t=2.981, P＜0.01);伤后3个月ADL评分观察组为(80.19±32.91)分,对照组为(63.85±36.78)分,观察组高于对照组,差异具有统计学意义(t=3.198, P＜0.01)。结论 低温治疗可显著降低重度颅脑损伤患者血浆内皮素-1水平,改善预后。
Abstract
Objective To explore the effect of hypothermia treatment on endothelin-1 (ET-1) in patients with severe traumatic brain injuries.Methods Clinical data of 52 patients with severe traumatic brain injuries treated at the department of neurosurgery (cerebral hemorrhage) in Shandong Provincial Corps Hospital of PAP from June 2015 to June 2020 were analyzed retrospectively. The patients were divided into hypothermia treatment group (observation group) and control group with 26 patients in each group. The control group were treated with conventional treatment, and the observation group were treated with hypothermia combined with conventional methods. ET-1 changes, intracranial pressure,Glasgow Outcome Scale(GOS) and ability of daily life(ADL) were compared to assess the efficacy.Results ET-1[(124.6±10.2),(91.7±8.4), (66.2±5.5),(45.4±4.6)ng/L] in the observation group on the 3,5,7 and 14 days after treatment were significantly lower than that in the control group [(130.4±8.7),(99.6±10.6),(72. 8±9.8),(52.0±6.8)ng/L], and the difference was statistically significant(P<0.05). Intra-cranial pressure[(18.0±3.2), (15.5±4.3), (14.5±3.2), (13.0±3.5) mmHg] in the observation group on the 3, 5, 7 and 14 days after treatment was significantly lower than that in the control group[ (19.8±4.0), (18.4±4.6), (17.5±3.7), (16.2±3.7) mmHg ](P<0.05), and the difference was statistically significant(P<0.05). GOS scores of the patients in the observation group (4.12±0.99) were higher than those in the control group (3.54±1.07) after three months, and the difference was statistically significant (t=2.981, P＜0.01). ADL scores of the patients in the observation group (80.19±32.91) were higher than those in the control group (63.85±36.78) after three months, and the difference was statistically significant (t=3.198, P＜0.01).Conclusions Hypothermia treatment can effectively lower the serum level of ET-1 and significantly improve prognosis in the severe traumatic brain injury patients.
关键词
低温治疗 /
神经外科 /
重症患者 /
血浆内皮素-1
Key words
hypothermia treatment /
neurosurgery /
severe patient /
endothelin-1
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