Study On Changes Of Intracranial Pressure, TNF-? And IL-6 During Mild Hypothermia Treatment Of Traumatic Severe Brain Injury

Objective:To observe the effect of mild hypothermia on intracranial pressure during the treatment of severe traumatic brain injury.To observe the effect of mild hypothermia on the levels of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)in serum during severe traumatic brain injury.To study the effect of mild hypothermia therapy on long-term prognosis of patients with severe traumatic brain injury.Methods:1 Seventy-two patients(3?GCS <8 points)with severe traumatic brain injury(STBI)admitted to neurosurgery department from February 2016 to September 2017 were selected.All patients were divided into control group and mild hypothermia group with 36 cases in control group and mild hypothermia group.The patients in both groups decided whether they needed emergency craniotomy or not according to their condition,and the operation was completed within 24 hours after admission.After admission,the patients in both groups underwent head drilling.intracranial pressure monitoring probe was placed under temporal lobe or frontal cortex,and the data were recorded regularly.2 The control group: after craniotomy(or conservative)treatment,given nutrition cranial nerve,acid suppression fluid infusion,dehydration to reduce intracranial pressure and anti-infection symptomatic treatment;Mild hypothermia group: patients were given mild hypothermia treatment after injury or 12 h after operation,so that the patient's body temperature was controlled at 32 �C ~ 35 �C,maintain mild hypothermia for 24 h ~ 168 h,and slowly reheated at 0.1 �C per hour after stable condition.3 Venous blood was taken from patients in mild hypothermia group and control group at 24 h,72 h and 168 h after craniocerebral injury.IL-6 kit and TNF-? kit were injected.the content of IL-6 and TNF-? was determined by ELISA.4 The intracranial pressure of patients in mild hypothermia group and control group was observed and recorded from 24 h to 168 h after craniocerebral injury by intracranial pressure monitor,and the intracranial pressure was recorded in detail.5 Observe and record the incidence of arrhythmia,falling pneumonia and limb venous thrombosis in mild hypothermia group and control group.6 Six months after discharge,according to Glasgow outcome score(GOS)to assess the efficacy,according to the grade I to v grade.Grade I and grade ii were judged as poor efficacy.The third grade was judged as general efficacy,and the fourth grade and v grade were judged as good efficacy.The general effect and good effect were counted as good prognosis,and the proportion of patients with good prognosis in the group was calculated and compared with each other.7 The data were processed by SPSS 21.0 statistical software.P< 0.05 was statistically significant.Results:1 2 patients in mild hypothermia group and 5 patients in control group were declared clinically dead within 168 h due to ineffective rescue.the number of cases actually participated in the study was 34 in mild hypothermia group and 31 in control group;2 There was no significant difference between the two groups(P>0.05);3 There was no significant difference in intracranial pressure between mild hypothermia group and control group(P>0.05).The intracranial pressure of mild hypothermia group was significantly lower than that of control group at 72 h and 168h(P<0.05).There was no significant difference in intracranial pressure between mild hypothermia group and control group(P>0.05).The intracranial pressure of mild hypothermia group was significantly lower than that of control group at 72 h and 168h(P<0.05);4 The levels of IL-6 and TNF-? in serum of mild hypothermia group were lower than those of control group(P>0.05).The levels of IL-6 and TNF-? in serum of patients in mild hypothermia group were significantly lower than those in control group at 72 h and 168h(P<0.05,the difference was statistically significant);5 No serious complications occurred in mild hypothermia group after 6 months of treatment and 1 case of epilepsy occurred in the control group.the prognosis of mild hypothermia group was significantly higher than that of the control group(P<0.05,the difference was statistically significant);6 Mild hypothermia treatment compared with normal temperature treatment of severe craniocerebral injury patients,cardiopulmonary dysfunction and limb venous thrombosis and other complications did not improve significantly;7 Mild hypothermia treatment can shorten the ICU stay of patients with severe craniocerebral injury;Mild hypothermia therapy can shorten the total hospitalization time of patients with severe craniocerebral injury;Conclusion: Mild hypothermia therapy can reduce intracranial pressure and serum IL-6 and TNF-? levels in patients with severe craniocerebral injury,reduce mortality and improve long-term prognosis.