Abstract
Objective To investigate the application effect of a combined emergency protocol involving Early Goal-Directed Sedation(EGDS)and Intravascular Hypothermia Therapy(IVHT)in the treatment of severe craniocere-bral injury.Methods One hundred patients with severe craniocerebral injury admitted to Jinjiang Anhai Hospital from January 2022 to June 2025 were selected as the study subjects.According to the random number table method,they were divided into an observation group(EGDS combined with IVHT,n=50)and a control group(conventional treatment,n=50).The 30-day mortality,incidence of hydrocephalus,neurological function,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),cerebral perfusion pressure(CPP),intracranial pressure(ICP)],cerebral oxidative metabolism pa-rameters[jugular venous lactate(Lac),jugular venous oxygen saturation(SjvO2),cerebral arterial oxygen content(CaO2),cerebral oxygen extraction rate(CERO2),cerebral arteriovenous oxygen content difference(a-vDO2)],and incidence of complications were compared between the two groups.Results The 30-day mortality(P=0.022)and 30-day incidence of hydrocephalus(P=0.003)in the observation group were lower than those in the control group.Before treatment,there were no significant differences in mRS score,BI score,HR,MAP,CPP,ICP,Lac,SjvO2,CaO2,CERO2,and a-vDO2 between the two groups(P>0.05).After treatment,the above neu-rological function scores,hemodynamic and cerebral oxidative metabolism parameters changed in both groups.The observation group showed significantly higher mRS score(P<0.001),BI score(P<0.001),MAP(P=0.036),CPP(P=0.006),SjvO2(P=0.003),and CaO2(P=0.001),and significantly lower HR(P<0.001),ICP(P<0.001),Lac(P<0.001),CERO2(P<0.001),and a-vDO2(P<0.001)compared to the con-trol group.The incidence of complications in the observation group was significantly lower than that in the control group(P=0.038).Conclusion In the treatment of patients with severe craniocerebral injury,the combined emergency protocol of EGDS and IVHT can reduce 30-day mortality and the incidence of hydrocephalus,improve neurological function and cerebral oxidative metabolism,stabilize hemodynamics,and lower the risk of complications.关键词
早期目标导向镇静/血管内低温治疗/重症颅脑损伤Key words
early goal-directed sedation/intravascular hypothermia therapy/severe craniocerebral injury
