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目的探讨不同启始时间应用颅脑降温治疗仪(电子冰帽)致头部轻度低温(亚低温)对高血压性脑出血预后的影响。方法72例高血压性脑出血患者随机分为治疗组和对照组,每组36例;每组再分为脑出血后第6、12和24h亚组,每亚组12例。在给予脑出血常规治疗的同时,治疗组使用电子冰帽。观察血肿体积、血肿周围水肿体积及神经功能缺损评分的变化。结果治疗后第7d与第21d的第6、12、24h开始致头部轻度低温的治疗组与相应时间的对照组血肿体积无显著性差异(P>0.05)。治疗后第21d的第6、12、24h启始的治疗组与相应时间的对照组血肿周围水肿体积比较有非常显著性差异(P<0.01)。治疗后第21d的第6、12h启始的治疗组与相应时间对照组神经功能缺损评分有非常显著性差异(P<0.01),第24h的两组间有显著差异(P<0.05)。结论第6、12和24h启始应用电子冰帽使头部轻度低温治疗高血压性脑出血,均能减轻血肿周围水肿,改善神经缺损功能,但对血肿的大小无影响。
Objective To investigate the effect of head mild hypothermia (mild hypothermia) on the prognosis of hypertensive intracerebral hemorrhage (ICH) using cranial cooling apparatus (electronic ice cap) at different initial stages. Methods 72 patients with hypertensive intracerebral hemorrhage were randomly divided into treatment group and control group, 36 cases in each group. Each group was further divided into 6, 12 and 24h subgroups after intracerebral hemorrhage, 12 cases in each subgroup. While giving conventional treatment of cerebral hemorrhage, the treatment group used an electronic ice cap. Changes in hematoma volume, edema volume around hematoma, and neurological deficit scores were observed. Results There was no significant difference in the hematoma volume between the 6th, 12th and 24th hour after the first 7th and the 21st day of treatment in the mild hypothermia treatment group and the control group at the corresponding time (P> 0.05). There was a significant difference in the volume of edema around the hematoma between the treatment group started at the 6th, 12th and 24th hours after the treatment and the control group at the corresponding time (P <0.01). Neurological deficit score of the 6th, 12th hour treatment group and the corresponding time control group on the 21st day after treatment was significantly different (P <0.01), and there was significant difference between the two groups at the 24th hour (P <0.05). Conclusion On the 6th, 12th and 24th hour, the application of electronic ice caps to mild hypothermia in the head treated hypertensive intracerebral hemorrhage can reduce edema around the hematoma and improve the function of nerve defect, but had no effect on the size of the hematoma.