Effect Of Mild Hypothermia On MMP-9, Intracranial Pressureand Cerebral Blood Flow Dynamics Of Patients With Severe Head Injury

Objective:To investigate the therapeutic mechanism and clinical effect of mild hypothermia(MHT) on patients with severe head injury.Methods:50 patients with severe head injury treated in our hospital from Jan 2013 to Apr 2014 were selected and divided into 2 groups using random number table(25 cases each group). All patients were treated with standardlarge trauma craniotomyand conventional therapy, the experimental group also received MHT 1~3h after operation. MMP-9, intracranial pressure(ICP), cerebral blood flowdynamics, the complications, the scores of Glasgow coma score, and scores of Glasgow outcome scale of the 2 groups were compared.Results: 1. 1d after treatment, MMP-9 of observation group and control group were(124.94±28.24)ng/ml、(138.41±23.26)ng/ml,there was no significantly difference between 2 group(t=2.515,P>0.05); 3d,5d,7d after treatment, MMP-9 of observation group were(87.23±20.67)、(79.44±35.89)、(45.55±34.62), MMP-9 of control group were(114.35±21.62)、(148.45±31.20)、(121.38±32.93), the difference was statistically significant(t=4.621,7.246,8.141,P<0.01).2. 1d after treatment, ICP of observation group and control group were(17.89±3.25)、(19.03±3.32),there was no significantly difference between 2 group(t=2.145,P>0.05). 3d,5d,7d after treatment, ICP of observation group were(16.34±2.49)、(16.52±3.10)、(10.45±3.13), ICP of control group were(22.73±3.77)、(24.42±3.43)、(15.84±2.56), the difference was statistically significant(t=5.156,7.561,5.914,P<0.01).3. 1d,3d after treatment, Vs of observation group were(87.51±7.21)cm/s、(88.13±9.14)cm/s, Vs of control group were(83.24±8.51)cm/s、(82.24±8.62)cm/s, there was no significantly difference between 2 group(t=1.621,2.521,P>0.05), Vm of observation group were(49.54±7.54)cm/s、(51.77±8.15)cm/s, Vm of control group were(48.22±8.62)cm/s、(44.25±9.53)cm/s,there was no significantly difference between 2 group(t=1.824,2.929,P>0.05); PI of observation group were(0.70±0.26)、(0.69±0.31), PI of control group were(0.71±0.19)、(0.72±0.24), there was no significantly difference between 2 group(t=1.034,2.834,P>0.05); 5d, 7d after treatment, Vs of observation group were(92.14±8.14)、(93.51±9.10), Vs of control group were(77.61±9.92)、(80.51±8.62), the difference was statistically significant(t=4.241,4.881,P<0.01); Vm of observation group were(58.32±7.92)、(59.44±8.24), Vm of control group were(39.52±8.30)、(40.32±9.24), the difference was statistically significant(t=5.621,6.141,P<0.01),PI of observation group were(0.62±0.28)、(0.53±0.43), PI of control group were(0.79±0.31)、(0.83±0.32), the difference was statistically significant(t=5.617,6.146,P<0.01).4. there was no difference in the GCS score between observation group(5.24±3.31)and control group(5.92±4.67)before treatment(P>0.05). After treatment, the GCS score in observation group(12.73±2.25)was higher than that in control group(9.21±2.73)(P<0.05).5. 6m after treatment, the good rate of glasgow outcome scale in experimental group(60.00%) was higher than that in control group(32.00%), while the death rate in experimental group(16.00%) were lower than that in control group(36.00)(P<0.05). 6. there was no difference in complication rate between the two groups(40.00% VS 48.00%)(P>0.05)。 Conclusion:MHTcan effectively improve MMP-9, ICP and cerebral blood flowdynamics of patients with severe head injury.