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目的 研究亚低温治疗对大面积脑梗死患者血糖、血乳酸、颅内压的影响及其临床疗效。方法 发病24h内入院的大面积脑梗死患者30例,随机分为亚低温治疗组和对照组,各15例。亚低温组给予32~34℃的低温治疗并于治疗前后持续监测颅内压;两组患者分别于入院时、第2天和第4天测定血糖、血乳酸水平,并采用神经功能缺损评分量表评估患者的预后。结果 亚低温组患者急性脑梗死后颅内压为(14 2±4 2)mmHg(1mmHg=0 133kPa), 经(32±9)h的低温治疗后,明显下降至(11. 3±2. 8)mmHg;亚低温组治疗结束时血糖和血乳酸分别下降了2 53mmol/L和2 .48mmol/L,与对照组相比,高血糖高乳酸血症得到明显改善。低温治疗期间未发生严重并发症,预后相对较好。结论 亚低温治疗大面积脑梗死安全有效,是临床上值得进一步研究应用的脑保护手段。
Objective To investigate the effects of mild hypothermia on blood glucose, blood lactate and intracranial pressure in patients with large area cerebral infarction and its clinical efficacy. Methods Thirty patients with large-area cerebral infarction admitted within 24 hours after onset were randomly divided into mild hypothermia treatment group and control group, 15 cases each. The patients in the mild hypothermia group were treated with hypothermia at 32 ~ 34 ℃ and the intracranial pressure was monitored before and after treatment. The blood glucose and blood lactate levels were measured at admission, on the 2nd and 4th days in the two groups, and the neurological deficit score The table evaluates the patient’s prognosis. Results The intracranial pressure of the mild hypothermia group was (14 2 ± 4 2) mmHg (1 mmHg = 0 133 kPa) after acute cerebral infarction, and decreased significantly to (11.3 ± 2) after hypothermia treatment for 32 ± 9 h. 8) mmHg. The levels of blood glucose and blood lactate decreased by2.53mmol / L and2.48mmol / L at the end of mild hypothermia treatment, respectively. Compared with the control group, hyperglycemia and hyperlacticionia were significantly improved. No serious complications occurred during hypothermia and the prognosis was relatively good. Conclusion Mild hypothermia treatment of large-area cerebral infarction safe and effective, is worthy of further clinical study of brain protection.