方浩威+林菡+余映丽++黄晓芸++王明霞

[摘要]目的 探討头部亚低温治疗高血压性脑出血的临床效果。方法 选取2014年2月～2016年2月我院收治的110例高血压性脑出血患者，分为观察组（n=55）与对照组（n=55）。对照组患者实施常规治疗，观察组患者实施头部亚低温治疗，比较两组患者的临床效果。结果 两组患者治疗前的颅内压比较，差异无统计学意义（P>0.05）；治疗第1、2、5、7天，观察组患者的颅内压明显低于对照组，差异有统计学意义（P<0.05）。观察组患者的总并发症发生率为10.91%，明显低于对照组的32.73%（χ2=7.674，P=0.006）。两组患者治疗前的GCS和NIHSS评分比较，差异无统计学意义（P>0.05）；治疗2周后，观察组患者的GCS评分明显高于对照组，NIHSS评分明显低于对照组，差异有统计学意义（P<0.05）。观察组患者的日常生活能力评分总有效率为92.7%，明显高于对照组的76.4%（χ2=5.636，P=0.018）。结论 头部亚低温治疗高血压性脑出血能有效降低患者的颅内压及并发症发生率，改善患者的神经功能缺损和预后，降低患者的死亡率，值得临床推广应用。

[关键词]头部亚低温治疗；高血压性脑出血；颅内压

[中图分类号] R743.34 [文献标识码] A [文章编号] 1674-4721（2017）04（a）-0062-03

Clinical effect of head mild hypothermia in treating hypertensive cerebral hemorrhage

FANG Hao-wei LIN Han YU Ying-li HUANG Xiao-yun WANG Ming-xia

Internal Medicine-Neurology，Dongguan Houjie Hospital in Guangdong Province，Dongguan 523945，China

[Abstract]Objective To explore the clinical effect of head mild hypothermia treating hypertensive cerebral hemorrhage.Methods 110 patients with hypertensive cerebral hemorrhage treated by our hospital from February 2014 to February 2016 were selected and divided into observation group （n=55） and control group（n=55）.The control group was given general treatment，and the observation group was given head mild hypothermia.The clinical effect between two groups was compared.Results The intracranial pressure had no significant difference between two groups before treatment （P>0.05），after treatment for 1，2，5 and 7 days，the intracranial pressure in the observation group was obviously lower than those of control group，and the difference was significant （P<0.05）.The total incidence rate of complications in the observation group was 10.91%，and it was obviously lower than that was 32.73% in the control group，and the difference was significant （χ2=7.674，P=0.006）.Before treatment，the GCS and NIHSS score between two groups had no significant （P>0.05），after treatment for 2 weeks，the GCS score in the observation group was obviously higher than that of control group，while NIHSS score was obviously lower than that of control group，and the difference was significant （P<0.05）.The total effective rate of daily life ability score in the observation group was 92.7%，and it was obviously higher than that in control group（76.4%），and the difference was significant （χ2=5.636，P=0.018）.Conclusion Head mild hypothermia treating hypertensive cerebral hemorrhage can effectively reduce the intracranial pressure and incidence rate of complications，improve neurological deficit and prognosis，reduce the mortality of patients and it is worthy of clinical promotion and application.

[Key words]Head mild hypothermia treatment；Hypertensive cerebral hemorrhage；Intracranial pressure

高血壓性脑出血是高血压患者最为严重的临床并发症，具有高致残率和高致死率的特点，如不及时治疗则可能导致脑水肿的出现，严重威胁患者的身体健康和生命安全[1]。以往的治疗是采取内外科结合治疗的方式，治疗效果并不理想。头部亚低温（33～35℃）治疗已被动物实验及临床研究证实[2]，能够改善脑出血患者的神经功能缺损和预后，为此，我院探讨采用头部亚低温治疗高血压性脑出血的效果，现报道如下。

1资料与方法

1.1一般资料

选取2014年2月～2016年2月我院收治的110例高血压性脑出血患者作为研究对象，患者病症状况均符合高血压性脑出血的临床诊断标准[3]。将患者随机分为两组，观察组55例，男39例，女16例；年龄47～72岁，平均（65.5±0.5）岁。对照组55例，男36例，女19例；年龄50～72岁，平均（64.5±0.5）岁。两组患者在年龄、性别等方面比较，差异无统计学意义（P>0.05），具有可比性。