The Effect Of Treatment Of Severe Traumatic Brain Injury With Mild Hypothermia On Cell Apoptosis

Objective:Mild hypothermia on severe head injury patients with combined therapy, dynamic monitoring of intracranial pressure change and the soluble Fas changes of the patient's cerebrospinal fluid was observed to analyze the clinical results of mild hypothermia therapy and to explore the impact of mild hypothermia on nerve cells' apoptosis and necrosis.Methods:40 cases who were hospitalized in the department of neuronal,the Affiliated Hospital of Chinese PeoPle's Armed Ploice force from February 2008 to December 2008 with severe craniocerebral injury(GCS≤8 points) were admitted to this study,patients were ramdomized into the mild hypothermia group and.control group.the hypothermia-treated group was 20 cases and So did the conventional therapy group.The patients in the hypothermia-treated groupwere given mild hypothermia treatment within 24 hours afer trauma,to maintain rectal temperature at 33℃～35℃,to maintain this therapy with 1～5 days.drug treatment of the conventional therapy group and the hypothermia-treated group was the same:At the same time we monitored the patient's vital signs,intracranial pressure(ICP) and so on, observed changes of the disease,prevented and handled various complications,the patients soluble Fas levels of cerebrospinal fluid in two groups of patients with severe craniocerebral injury were analyzed using enzyme-linked immunosorbent assay measurement.Finally,we conducted a GOS score at the end of treatment after months and analyzied its clinical effects using statistical analysis software package SPSS13.0.Results:the intracranial pressure of both group at the early stage after injury were higher than normal and it decreased gradually,but ICP gap between the two group was gradual significant(P＜0.05).Patient mortality Rate in the mild hypotherrnia group was lower than the control group,and it had a better recovery rate(P＜0.05). cerebrospinal fluid Soluble Fas concentration reached a peak when 2～3days post trauma and remained at plateau from the on.The soluble Fas level in cerebrospinal fluid in hypothermia-treated group were significantly lower than conventional therapy group(P＜0.05). Conclusions:Conventional treatment combining use of mild hypothermia on severe head injury patients could reduce intracranial pressure rapidly and this combined therapy can improve the patient's prognosis.Cell apoptosis and cell necrosis played important role ater severe head injury simultaneously.Mild hypothermia can reduce cell apoptosis and cell necrosis occurrence.So it can relieve secondary brain injury.