Effect Of Endovascular Hypothermia On Cerebral Blood Flow,NSE And S100 Protein In Patients With Severe Traumatic Brain Injury

ObjectiveTo investigate the effect of mild hypothermia controlled by endovascular hypothermia apparatus on cerebral blood flow,serum neuron-specific enolase(NSE)and serum calcium-binding protein(S100)in severe traumatic brain injury(s TBI)patients,and provide a basis and reference for clinical treatment.Methods62 cases of s TBI patients admitted to the ICU of the hospital from June 2017 to February 2019 were selected and randomly divided into the control group(n=31cases)and the observation group(n=31 cases).After admission,both groups were given conventional treatment and intervention.The control group was treated with ice blanket combined with ice cap cooling,the observation group was treated with intravascular cooling,and the patients in the two groups were followed up for 28 days after treatment.Case data were consulted,and gender,age,weight,past history,craniocerebral injury,GCS score at the time of inclusion,treatment status and injury type were recorded in the two groups.The NSE level was measured by automatic chemiluminescence immunoanalyzer 3 days before admission to ICU,1,2 and 3 days after treatment.The level of S100 protein was determined by enzyme-linked immunosorbent assay(ELISA).Blood gas level and blood oxygen saturation of jugular vein bulb were measured by blood gas analyzer.Both groups were followed up for 28 days after treatment,and patient mortality,GCS score,days in ICU,hospitalization days,coma and mechanical ventilation time were recorded.SPSS Pearson correlation analysis software was used to analyze the correlation between the prognosis of patients with severe craniocerebral injury and the levels of NSE and S100 proteins.The general data,the determination of markers of nerve injury,the blood oxygen saturation(Sjv O2)of the internal jugular vein bulb and the treatment prognosis of the two groups were compared.All data in this study were processed with SPSS23.0 software.Results(1)There was no statistically significant difference between the observation group and the control group in gender,age,BMI,educational level,complications(hypertension,hyperlipidemia,diabetes,myocardial infarction),cause of injury,GCS score and treatment time after injury(P>0.05).(2)The NSE levels of the observation group and the control group at levels 1,2 and 3 days after treatment were lower than those before admission to ICU(P<0.05).After treatment,the NSE levels of the observation group were lower than those of the control group(P<0.05).(3)The levels of S100 protein in the observation group and the control group were lower than those before ICU admission(P<0.05).The level of S100 protein in the observation group was lower than that in the control group(P<0.05).(4)The Na+ and CL-levels of the observation group and the control group were not statistically significant on 28 days after treatment(P>0.05).The K+,PH and BE levels of the two groups were lower on28 days after treatment than before treatment(P<0.05).Sjv O2 level was higher than that before treatment(P<0.05).The K+,PH and BE levels of the observation group were lower than those of the control group on 28 days after treatment(P<0.05).Sjv O2 level was higher than that of the control group(P<0.05).(5)There was no statistical significance in the 28-day mortality,medium disability,severe disability and plant survival rate of the two groups(P>0.05).The 14 d mortality of the observation group was lower than that of the control group(P<0.05).The good recovery rate of the observation group was higher than that of the control group on 28 days after treatment(P<0.05).(6)the GCS score of the observation group 28 days after treatment was higher than that of the control group(P<0.05).The duration of coma and mechanical ventilation in the observation group was shorter than that in the control group(P<0.05).There was no statistical significance in length of stay or total length of stay in ICU between the observation group and the control group after treatment(P>0.05).(7)SPSS Pearson correlation analysis results showed that the prognosis of patients with severe craniocerebral injury was negatively correlated with NSE and S100 protein levels(P<0.05).ConclusionMild hypothermia controlled by endovascular hypothermia is accurate and effective,it can reduce NSE and S100 level in s TBI patients,improve blood gas and blood oxygen saturation of jugular vein bulb,reduce clinical mortality,and obtain a good prognosis.Therefore,Monitoring NSE and S100 protein levels in s TBI patients is of great significance in evaluating prognosis and guiding clinical treatment.