Department of Critical Care Medicine, The Central of Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China.
Medicine (Baltimore). 2023 Mar 10;102(10):e32921. doi: 10.1097/MD.0000000000032921.
This study is to explore the application of target temperature management and therapeutic hypothermia in the treatment of neuroprotection patients with severe traumatic brain injury and its effect on oxidative stress. From February 2019 to April 2021, 120 patients with severe traumatic brain injury cured were selected in our hospital. The patients were randomly divided into control and experimental groups. The control group accepted mild hypothermia therapy. The experimental group took targeted temperature management and mild hypothermia therapy. This study compared the prognosis, National Institute of Health Stroke Scale (NIHSS) score, oxidative stress level, brain function index and the incidence of complications in different groups. The prognosis of the experimental group was better (P < .05). After treatment, the NIHSS score lessened. The NIHSS score of the experimental group was lower at 3 and 6 weeks after treatment (P < .05). Following treatment, the level of superoxide dismutase-1 in the experimental group was higher and the level of malondialdehyde was lower (P < .05). After treatment, the brain function indexes of patients lessened. The experimental group's myelin basic protein, neuron specific enolase and glial fibrillary acidic protein indexes were lower (P < .05). The incidences of pendant pneumonia, atelectasis, venous thrombosis of extremities and ventricular arrhythmias in the experimental group were remarkably lower (P < .05). Targeted temperature management and mild hypothermia treatment can improve neurological function, maintain brain cell function, and reduce stress-reactions risk. The incidence of complications during hospitalization was reduced.
本研究旨在探讨目标温度管理和治疗性低温在保护严重创伤性脑损伤神经保护患者中的应用及其对氧化应激的影响。2019 年 2 月至 2021 年 4 月,我院选取 120 例治愈的严重创伤性脑损伤患者,患者随机分为对照组和实验组,对照组接受亚低温治疗,实验组采取目标温度管理联合亚低温治疗。本研究比较了不同组的预后、美国国立卫生研究院卒中量表(NIHSS)评分、氧化应激水平、脑功能指标和并发症发生率。实验组预后较好(P < 0.05)。治疗后,NIHSS 评分降低,实验组治疗后 3 周和 6 周 NIHSS 评分较低(P < 0.05)。治疗后,实验组超氧化物歧化酶-1 水平升高,丙二醛水平降低(P < 0.05)。治疗后,患者的脑功能指标降低,实验组的髓鞘碱性蛋白、神经元特异性烯醇化酶和神经胶质纤维酸性蛋白指标较低(P < 0.05)。实验组悬雍垂肺炎、肺不张、四肢静脉血栓和室性心律失常的发生率显著降低(P < 0.05)。目标温度管理和亚低温治疗可以改善神经功能,维持脑细胞功能,降低应激反应风险,降低住院期间并发症的发生率。