恒温毯保温对重型脑外伤患者血管内低温治疗效果的影响

doi:10.3969/j.issn.1006-9771.2020.07.024

Abstract

Abstract:

Objective To investigate the effect of constant temperature blankets on intravascular hypothermia for severe traumatic brain injury (sTBI). Methods A total of 112 inpatients with sTBI from January, 2013 to December, 2018 were reviewed. They were divided into control group (n = 58) and observation group (n = 54) according to whether a self-warming blanket was used. They were assessed with Bedside Shivering Assessment Scale (BSAS). Their dosages of anti-shivering medicine, coagulation and intracranial pressure were recorded. The scores of Glasgow Outcome Scale Extended (GOSE) and the mortality one, six and twelve months after discharge were observed. Results The incidence and severity were less in the observation group than in the control group (χ² = 16.212, P < 0.01). The dosage of anti-shivering medicine was less in the observation group than in the control group ( t > 1.269, P < 0.05). The hypercoagulation relieved significantly six hours after hypothermia in the observation group, and it was stable twelve hours after hypothermia. For the control group, the hypercoagulation relieved significantly twelve hours after hypothermia, and it was stable 24 hours after hypothermia. The intracranial pressure decreased more in the observation group than in the control group. The GOSE score and the mortality were less in the observation group than in the control group ( t > 1.168, P < 0.05) one, six and twelve months after discharge. Conclusion Application of self-warming blankets in intravascular hypothermia for sTBI may relieve shivering, hypercoagulation and intracranial pressure, to improve the outcome of patients.

Key words: severe traumatic brain injury, self-warming blanket, intravascular hypothermia, shivering, hypercoagulation, intracranial pressure

CLC Number:

R651.1

LIAO Li-ping,CHEN Peng,WANG Ke,WU Xiao-su,CHEN Ying,ZHANG Xi,ZHAO Jie,WANG Jun,QU Xin. Effect of Self-warming Blankets on Intravascular Hypothermia for Severe Traumatic Brain Injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 863-868.

Figures/Tables 9

References 33

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组别	n	性别(n)		年龄(岁)	病程(d)	损伤类型(n)
组别	n	男	女	年龄(岁)	病程(d)	硬膜下血肿	硬膜外血肿	颅内血肿	脑挫裂伤	弥漫性轴索损伤	蛛网膜下腔出血
对照组	58	32	26	37.16±12.09	217±11.65	14	12	11	9	7	5
观察组	54	28	26	36.75±11.79	209±10.16	11	11	9	8	8	7
χ²/t值		0.632		0.115	0.358	0.996
P值		0.715		0.366	0.524	0.816

组别	n	0级	1级	2级	3级
对照组	58	28	18	6	6
观察组	54	46	4	2	2

组别	n	丁螺环酮	哌替啶
对照组	58	79.82±7.16	471.38±49.63
观察组	54	50.11±6.23	367.95±50.63
t值		1.269	1.766
P值		0.037	0.022

组别	n	1个月	6个月	12个月
对照组	58	4.12±0.16	4.65±0.29	4.71±0.35
观察组	54	4.31±0.21	5.03±0.17	5.66±0.51
t值		1.081	1.273	1.756
P值		0.039	0.032	0.037

组别	n	1个月	6个月	12个月
对照组	58	4	7	8
观察组	54	1	2	4
P值		0.035	0.042	0.046

Effect of Self-warming Blankets on Intravascular Hypothermia for Severe Traumatic Brain Injury

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