| 朱 彬,陈 伟,徐凤科,虞 猛,张洪志,道日娜,包金锁.亚低温联合手术治疗对重型颅脑损伤患者血清ET-1、Ang-1、G-CSF及预后的影响[J].,2018,(18):3502-3505 |
| 亚低温联合手术治疗对重型颅脑损伤患者血清ET-1、Ang-1、G-CSF及预后的影响 |
| Effect of Mild Hypothermia Combined with Surgical Treatment on Serum ET-1, Ang-1, G-CSF and Prognosis in Patients with Severe Traumatic Brain Injury |
| 投稿时间：2018-04-25 修订日期：2018-05-21 |
| DOI：10.13241/j.cnki.pmb.2018.18.022 |
| 中文关键词: 颅脑损伤 亚低温 内皮素-1 血管生成素-1 粒细胞集落刺激因子 |
| 英文关键词: Brain injury Mild hypothermia ET-1 Ang-1 G-CSF |
| 基金项目:内蒙古自治区自然科学基金项目(2014MS0874) |
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| 中文摘要: |
| 摘要 目的：研究亚低温联合手术治疗对重型颅脑损伤患者血清内皮素-1（endothelin-1，ET-1）、血管生成素-1（Angiopoietin-1，Ang-1）、粒细胞集落刺激因子（Granulocyte-colony stimulating factor，G-CSF）及预后的影响。方法：选取我院收治的118例重型颅脑损伤患者，按照抛硬币法分为治疗组和对照组，每组各59例。两组患者入院后均进行手术治疗，治疗组则在术后进行亚低温治疗。观察并比较两组患者临床治疗效果、治疗前后血清ET-1、Ang-1、G-CSF水平变化情况、不良反应发生情况以及预后情况。结果：治疗后，治疗组第1、3、7、14天的颅内压均显著低于对照组，两组组间比较差异显著（P<0.05）。两组患者血清ET-1、Ang-1、G-CSF较治疗前显著下降，且治疗组血清各指标水平改善情况显著优于对照组（P<0.05）。两组患者均发生脑梗死、脑积水、癫痫、肺部感染、切口脑脊液瘘以及应激性溃疡出血等并发症，但两组差异无统计学意义（P>0.05）。治疗组患者的预后良好率达到49.15%，显著高于对照组的13.56%；而治疗组的死亡率（5.08%）则明显低于对照组（13.56%），两组差异显著（P<0.05）。结论：亚低温联合手术治疗较单纯手术治疗可以更好的改善患者血清ET-1、Ang-1以及G-CSF水平，其不良反应发生率也更低，从而可以更好的改善患者的预后情况，值得在临床上推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of mild hypothermia combined with surgical treatment on serum ET-1, Ang-1, G-CSF and prognosis in patients with severe traumatic brain injury. Methods: 118 cases with severe craniocerebral injury were researched, ac- cording to the flip coin method they were divided into the treatment group and the control group, 59 cases in each group. Both groups were treated by surgery after admission, and the treatment group was treated with mild hypothermia after operation. The clinical effects, the changes of serum ET-1, Ang-1 and G-CSF levels before and after treatment, the incidence of adverse reactions and prognosis were observed and compared between the two groups. Results: After treatment, the intracranial pressure of the treatment group was significant- ly lower than that of the control group on the 1st, 3rd, 7th and 14th days after treatment. There was significant difference between the two groups (P<0.05). The levels of serum ET-1, Ang-1 and G-CSF in both groups were significantly lower than those before treatment, And the serum levels of ET-1, Ang-1 and G-CSF in treatment group were significantly better than those in control group (P<0.05). Complica- tions of cerebral infarction, hydrocephalus, epilepsy, pulmonary infection, incisional cerebrospinal fluid fistula and stress ulcer bleeding occurred in both groups, but there was no significant difference between the two groups (P>0.05). The good prognosis of the treatment group was 49.15%, which was significantly higher than that of the control group (13.56%), while the treatment group's mortality rate (5.08%) was significantly lower than that of the control group (13.56%), with significant difference between the two groups (P<0.05). Conclusion: Mild hypothermia combined with surgical treatment alone can not only better the level of serum ET-1, Ang-1 and G-CSF in patients with lower incidence of adverse reactions, thus better to improve the prognosis of patients, it is worthy of clinical application. |
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