摘要
目的探讨高渗盐液(HTS)在急诊与院前急救对严重脑外伤颅内高压合并休克病人的治疗作用。方法回顾性分析我院2003年1月～2008年1月期间随机抽取严重颅脑创伤合并休克患者的病例资料(n=63),对早期使用7.5%HTS为患者液体降颅压复苏病例作为A组(n=32),对早期使用20%甘露醇为患者液体降颅压复苏病例作为B组(n=31)。维持平均动脉压(MAP)基本不变时,分别监测两组病例中的3小时内颅内压(ICP)、脑灌注压(CPP)、心率(HR)、尿量(UPD)的变化及患者的转归。结果在降ICP效果方面,两组病例都有明显降颅压效果,对比无显著差异,在维持降颅压时间上,A组维持的时间要比B组长,有显著差异;维持MAP基本不变时,CPP、HR、UPD、转归上A组要优于B组,两组对比P<0.05,差别具有统计学意义。结论HTS适用于重度脑外伤合并创伤性休克的早期液体复苏治疗,值得在急诊与院前急救的临床作为一线药物推广。
Objective To explore the therapeutical effect of hypertonic sodium for acute severe traumatic brain injury and traumatic shock in emergency and pre-hospital care. Methods 163 with acute severe traumatic brain injury and traumatic shock were selected randomly and studied retrospectively from Jan 2003 to Jan 2008. in earlier period ,32 case （A group） received 7.5% HTS treatment and 3 lcase（B group） with 20%mannitol treatment for reducing Intracranial pressure and resuscitation. Keeping basic mean arterial pressure invariably, All case in two group were monitored Intracranial pressure ,cerebral perfusion pressure, heart rate, urinary production in 3 hour and the patients＇ prognosis .Compared in the two group. Results Effect of reducing Intracranial pressure was effective and there was no statistical significance in two group, Keeping basic mean arterial pressure invariably, Keeping time of Intracranial pressure in B group was shorter than A group, there was statistical significance in two group, cerebral perfusion pressure, heart rate and urinary production in A group were super to B group, there was statistical significance in two group. Conclusion the therapeutical effect of hypertonic sodium was refer to acute severe traumatic brain injury and traumatic shock in earlier period in emergency and prehospital care .which to take as lot medicine is worth spreading clinically.
出处
《当代医学》
2009年第4期80-82,共3页
Contemporary Medicine
关键词
高渗盐液
脑外伤
创伤性休克
甘露醇
hypertonic sodium traumatic brain traumatic shock mannitol
