Yan Yi, Tang Wen-yuan, He Jian-guo, Gao Jin-jian, Dan Wei, Zhong Dong, Yang Gang, Liu Ke, Huang Han-lin
Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Wai Ke Za Zhi. 2007 Jan 15;45(2):109-13.
To observe the changes of brain oxygen metabolism and neuroelectrophysiology after severe brain injury, and the effects of hypothermia on severe brain injury.
148 patients with severe brain injury (GCS 3 - 8, admitted within 10 hours from injury) were selected for this study. Patients were divided into 3 groups, Group GCS 7 - 8, Group GCS 5 - 6 and Group GCS 3 - 4. Every group were also randomly assigned to normothermia and hypothermia subgroup. Patients in the hypothermia group were cooled to 32 approximately 34 degrees C. SLSEP, BAEP, P(br)O(2) and rSaO(2) were recorded in each group at the same time.
In the Group GCS 7 - 8, N20 in SLSEP, I/V in BAEP and rSaO(2) were improved significantly after mild hypothermia treatment, and P(br)O(2) was decreased by hypothermia; In the Group GCS 5 - 6, N20 in SLSEP, I/V in BAEP and rSaO(2) were improved by hypothermia, and P(br)O(2) was decreased in hypothermia subgroup; In the Group GCS 3 - 4, no significant difference was found.
Mild hypothermia has a significant effect on patients of GCS 7 - 8 and a doubt effect on patients of GCS 5 - 6. It seem no effect on patients of GCS 3 - 4. Brain oxygen metabolism and neuroelectrophysiology are important to value the therapeutic effect on severe brain injury.
观察重型颅脑损伤后脑氧代谢及神经电生理变化，以及亚低温对重型颅脑损伤的影响。
选取148例重型颅脑损伤患者（格拉斯哥昏迷评分3 - 8分，伤后10小时内入院）进行本研究。患者分为3组，格拉斯哥昏迷评分7 - 8分组、格拉斯哥昏迷评分5 - 6分组和格拉斯哥昏迷评分3 - 4分组。每组再随机分为常温组和亚低温组。亚低温组患者体温降至32～34℃左右。同时记录每组患者的体感诱发电位（SLSEP）、脑干听觉诱发电位（BAEP）、脑组织氧分压（P(br)O(2)）和脉搏血氧饱和度（rSaO(2)）。
格拉斯哥昏迷评分7 - 8分组，亚低温治疗后体感诱发电位N20、脑干听觉诱发电位I/V及脉搏血氧饱和度明显改善，脑组织氧分压降低；格拉斯哥昏迷评分5 - 6分组，亚低温使体感诱发电位N20、脑干听觉诱发电位I/V及脉搏血氧饱和度改善，亚低温组脑组织氧分压降低；格拉斯哥昏迷评分3 - 4分组，差异无统计学意义。
亚低温对格拉斯哥昏迷评分7 - 8分患者有显著效果，对格拉斯哥昏迷评分5 - 6分患者效果存疑，对格拉斯哥昏迷评分3 - 4分患者似乎无效。脑氧代谢及神经电生理对评估重型颅脑损伤的治疗效果具有重要意义。
