Mechanism and effect of Double-lumen Y-shaped tube irrigation and drainage at low temperature fluid on cerebral hemorrhage / 中国综合临床

ABSTRACT

Objective To explore the mechanism and effect of Double-lumen Y-shaped tube treating patients with cerebral hemorrhage through irrigation and drainage at low temperature fluid.Methods Patients with cerebral hemorrhage were randomly divided into treatment group(27 cases) and control group(27 cases).All patients in two groups were treated with routine therapy and small bone flap craniotomy.Patients in control group were received treatment of single-lumen tube,while in treatment group were received treatment of double-lumen Y-shaped tube through irrigation and drainage at low temperature fluid (18-20℃).Neuron-specific enolase (NSE),tympanic temperature,NIHSS score and Barthel score were measured and analyzed respectively.Results Tympanic temperature at before treatment,2 days after treatment,l day after tube remove in treatment group were (37.6 ±0.8),(34.1 ±0.6),(37.1 ±0.6) ℃ respectively,and those in control group were (37.5 ± 0.9),(37.9 ± 1.1),(37.3 ± 0.7) ℃ respectively.NSE level and NIHSS score at pre-treatment,7th days and 14th days treatment were ((27.6 ±6.5),(21.8 ±6.1),(12.1 ±5.7)) μ,g/L,((17.8 ±4.3),(14.6±3.9),(11.1 ±3.1)) in treatment group and ((27.2 ±5.9),(29.3 ±5.6),(20.0 ±6.3)) μg/L,((17.1 ± 4.5),(16.1 ± 4.6),(15.0 ± 2.9)) in control group respectively.There were significant difference between two groups at different time(F within group =189.7,F interaction =17.12,F between group =18.41 ;F within group =53.88,F interaction =33.21,F between group =37.94 ; F within group =18.66,F interaction =12.91,F between group =13.76,P ＜0.001).Tympanic temperature reached level of mild hypothermia after 2 days in treatment group.NSE level and NIHSS score reached the lowest values after 14 days in treatment group.Barthel score after 30 days and 90 days treatment were (56.5 ± 15.3),(86.6 ± 13.9) in treatment group and (45.3 ±12.9),(72.3 ± 14.2) in control group.There were significant difference between two groups at different time (F within group =50.38,F interaction =78.53,F between group =79.92,P ＜ 0.001).Barthel score reached the highest level after 90 days in treatment group.Conclusion Dual chamber Y shape pipe application on cerebral hemorrhage after continuous low temperature washing plays the role in local mild hypothermia.Meanwhile it also can decrease the concentration of NSE,alleviate cerebral injury,and then improve the prognosis.