Effect Of Mild Hypothermia Therapy With Different Durations In Patients With Severe Traumatic Brain Injury

Objective Severe traumatic brain injurn(s TBI)is one of the most common diseases in the intensive care unit(ICU)for emergency treatment.The disease is characterized by extremely severe disease,rapid progress,and poor prognosis.With the rapid development of the social economy,the incidence of the disease is increasing year by year.Once it occurs,the condition and prognosis are often bad and very harmful to patients,families and society.Reasonable hypothermia treatment can quickly and effectively protect the brain in a variety of ways in the early stage of s TBI.However,the details of the specific treatment process are currently lack of standardization at home and abroad.There is no clear guideline recommendation in countries.There is more controversy,especially about the duration of hypothermia therapy.Most doctors in the clinic often use sub-hypothermia for 24 hours to 72 hours.Some doctors advocate the use of sub-hypothermia for 5 days to 14 days.There is no consensus on the specific hypothermia time course.Short-term treatment of mild hypothermia is difficult to achieve obvious therapeutic effect.Excessive time may bring complications and worsen the disease.Suitable hypothermia treatment time course requires a large number of basic experiments to explore,and a large number of clinical studies to verify.This study compared the mortality,complications and long-term prognosis of patients with s TBI in the duration of hypothermia treatment for 2 days and 5 days respectively,and explored the best treatment for mild hypothermia brain protection treatment in s TBI patients.Methods This was a randomized,prospective study.A total of 90 patients with s TBI admitted to ICU of our Hospital from August 2016 to December 2017 were selected prospectively as the subjects,and all patients were randomly divided into the conventional group(group A,n=30),the long-term mild hypothermia group(group B,n=30)and the short-term mild hypothermia group(group C,n=30).The group A was given only basic treatment,such as dehydration and intracranial pressure,nutritional support,maintain internal stability,etc.Patients with surgical indications should be treated with neurosurgery.Patients with ventilator indications should use ventilator to assist breathing.Patients can be treated with analgesic sedation as appropriate.The group B was treated with mild hypothermia after admission and the body temperature was controlled at 33-35?,lasting 5 days.The group C was treated with mild hypothermia after admission and the temperature was controlled at 33-35? for 2 days.The clinical effects of the three groups were compared in 6th day by observing the intracranial pressure(ICP),acute physiology and chronic health evaluation II(APACHE II score),complication rate and mortality after 6 days of treatment.Results There was no significant difference in ICP between the three groups before treatment(P>0.05),and the ICP was statistically significant on the 6th day after injury(P<0.05).And group C is higher than group B(P<0.05).The APACHE II scores of the three groups on the 6th day after injury were statistically significant(P<0.05),and the group C on the 6th day after injury was higher than that of the group B(P<0.05).The incidence of complications in the group A was higher than that in the group B and the group C(P<0.05).The incidence of complications in group C was higher than that in group B(P>0.05),but the mortality in group A was higher than that in group B(P<0.05).The mortality rate in the group C was higher than that in the group B(P>0.05).Conclusion The effect of mild hypothermia therapy on patients with s TBI was significant.Although longterm mild hypothermia therapy could not reduce the mortality rate significantly in a short period of time,it could reduce ICP and the risk of long-term death significantly.No significant increase in the incidence of patient complications.