Cancio L C, Wortham W G, Zimba F
General Surgery Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234.
Resuscitation. 1994 Jul;28(1):9-19. doi: 10.1016/0300-9572(94)90049-3.
Mild to moderate hypothermia has been employed since the 1940s in the treatment of acute blunt head trauma. The utility of hypothermia in ischemic injury has been confirmed, by both animal studies and clinical experience, in cardiovascular and neurological surgery. In blunt injury, though, only one prospective, randomized study has shown a statistically significant improvement in long term outcome. Clinical experience, animal data, proposed mechanisms, technical considerations, and potential risks are reviewed. Hypothermia remains controversial in the setting of blunt head injury but may prove to be a useful treatment modality.
自20世纪40年代以来,轻度至中度低温疗法一直被用于治疗急性钝性头部创伤。低温疗法在缺血性损伤治疗中的效用已在心血管和神经外科手术的动物研究及临床经验中得到证实。然而,在钝性损伤方面,仅有一项前瞻性随机研究显示长期预后有统计学上的显著改善。本文对临床经验、动物数据、提出的机制、技术考量及潜在风险进行了综述。在钝性头部损伤的情况下,低温疗法仍存在争议,但可能被证明是一种有用的治疗方式。