Effect of mild hypothermia on the brain edema of severe head injury
10.3321/j.issn:1673-4254.2000.06.015
- VernacularTitle:亚低温对重型颅脑损伤后脑水肿的影响
- Author:
Yong-Qin XIA
1
;
Ru-Xiang XU
;
Xiang-Yu WANG
Author Information
1. Zhujiang Hospital First Military Medical University
- Keywords:
brain injury;
severe;
mild hypothermia;
brain edema;
prognosis
- From:
Journal of Southern Medical University
2000;20(6):493-498
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of mild hypothermia on brain edema after severe head injury (SHI) and its clinical significance. Methods Thirty-six patients with SHI were randomly divided into conventional therapy group (control group) and mild hypothermia therapeutic group (therapeutic group), with 18 patients in each group. The patients in the therapeutic group were treated with ice-cap, ice-blanket and ice-bag and lytic cocktail Ⅰas adjuvants, and a rectal temperature of 33 ℃ was maintained for 3~5 d. Intracranial pressure (ICP) of all the patients after operation were monitored postoperatively. The size of brain edema was measured with CT on day 0, 1, 3, 7, 14, 21 respectively after SHI. The size of brain edema at the trauma cite and ICP as well as the clinical outcome were compared and analysed. Results ICP of the control and therapeutic groups were（2.87±0.26）kPa and (1.67±0.23) kPa respectively on day 3 (P<0.01), and were (3.15±0.24)kPa and (1.78±0.24) kPa respectively on day 7 after brain injury (P<0.01). The area of brain edema was the largest on day 14 in the control group (140.90±22.95 cm3)and on day 3 in the therapeutic group (95.83±14.97 cm3). At day 14 posttrauma, the edema area in therapeutic group was 42% smaller than that in the control group (P<0.05). The rates of consciousness recovery within a week were 22.2% (4/18) in the control group and 55.6% (10/18) in the therapeutic group (P<0.05). The rates of unfavorable prognosis was 61.1% (11/18) in the control group and 33.3% (6/18) in the therapeutic group. Conclusion Mild hypothermia treatment can improve the prognosis through alleviating brain edema and stabilizing ICP after SHI.
