摘要
目的探讨高渗盐水、甘露醇治疗重型颅内高压效果及对脑氧代谢影响效果。方法回顾性分析2019年1月-2022年12月本院和合作单位收治的55例重型颅内高压患者,按照随机数字表法的原则,分成观察组(n=30)与对照组(n=25)。对照组采用20%甘露醇干预,观察组采用3%高渗盐水干预。观察组两组输注前及输注完60min的颅内压、中心静脉压变化,同时监测患者输注前、输注完30min与输注后60min的脑氧代谢指标[脑氧饱和度(TOI)、脑组织血红蛋白浓度指数(THI)]。结果与输注前比较,两组患者在输注完60min颅内压、中心静脉压水平均降低,而观察组输注完60min的各指标水平低于对照组(P<0.05);与输注前比较,两组患者在输注完30min、60min的TOI与THI均升高,而观察组输注完30min、60min的指标均高于对照组(P<0.05)。结论针对重型颅内高压,应用高渗盐水与甘露醇均可降低颅内压及改善脑氧代谢,但是相比之下应用高渗盐水在降低颅内压及改善脑氧代谢上更明显。
Objective To investigate effect of hypertonic saline and mannitol on severe intracranial hypertension and cerebral oxygen metabolism.M e t h o d s The paper reviewed and analyzed 55 patients with severe intracranial hypertension admitted to our hospital and cooperating units from January 2019 to December 2022,including observation group(n=30)and control group(n=25).Control group was treated with 20%mannitol and observation group with 3%hypertonic saline.Changes of intracranial pressure and central venous pressure before and 60 minutes after infusion were observed between two groups,cerebral oxygen metabolism indexes[cerebral oxygen saturation(TOI),cerebral hemoglobin concentration index(THI)]were monitored before infusion,30 minutes after infusion and 60 minutes after infusion.Results Intracranial pressure and central venous pressure water of two groups decreased averagely at 60 min after infusion compared with before infusion,levels of each index in observation group were lower than control group at 60 min after infusion(P<0.05).TOI and THI of both groups increased at 30 and 60 minutes after infusion comared with before infusion,while indicators of observation group at 30 and 60 minutes after infusion were higher than control group(P<0.05).Conclusion Both hypertonic saline and mannitol can reduce Intracranial pressure and improve cerebral oxygen metabolism for severe intracranial hypertension,,but hypertonic saline is more effective in reducing Intracranial pressure and improving cerebral oxygen metabolism.
作者
何辉
HE Hui(Guangzhou City Panyu District Central Hospital,Guangzhou,Guangdong 511400)
出处
《智慧健康》
2023年第19期81-84,共4页
Smart Healthcare
基金
广州市番禺区科技计划项目《不同治疗剂量3%高渗盐水对神经危重症患者的颅内高压疗效研究》(项目编号:2020-Z04-076)。
关键词
重型颅内高压
高渗盐水
甘露醇
颅内压
脑氧代谢
Severe intracranial hypertension
Hypertonic saline
Mannitol
Intracranial pressure
Cerebral oxygen metabolism
