高渗钠液治疗小儿感染性颅内高压症26例分析  

Analysis of Hypertonic Saline in the Treatment of 26 Children with Infectious Intracranial Hypertension

作　　者：李乔俊[1] 岳少杰[1] 虞佩兰[1] 尹飞[1] 杨于嘉[1] 

机构地区：[1]中南大学湘雅医院儿科教研室,湖南长沙410008

出　　处：《医学临床研究》2005年第8期1045-1048,共4页Journal of Clinical Research

摘　　要：[目的]探讨高渗钠液在小儿感染性脑水肿颅内高压症中的治疗作用.[方法]回顾分析本院1992～2001年儿科住院的75例感染性颅内高压患儿的降颅压治疗.根据临床用药情况将75例患儿分成常规治疗组(RTG,n=49)和常规治疗加高渗钠液组(HTSG,n=26),并根据患儿年龄不同分成≤1岁组(n=41)、1～3岁组(n=18)、＞3岁组(n=16).于治疗后3 d内、4～5 d和5 d后观察脑脊液压力、颅内高压症状及体征的变化来判断疗效.[结果]1岁以内的患儿颅内高压发生率(83.67%)显著高于～3岁组(54.55%)及＞3岁组(53.33%)(P＜0.01);5 d后HTSG组的好转率(84.62%)明显高于RTG组(51.02%)(P＜0.01),而3 d内、4～5 d两组好转率差异无显著性(P＞0.05).HTSG组在各年龄组的疗效相似.HTSG组总有效率为84.62%,明显高于RTG组(51.02%)(P＜0.01),而无效率(15.34%)明显低于RTG组(48.98%)(P＜0.01).两组在治疗前后血清钠差异无显著性(P＞0.05).[结论]本文1岁以内的患儿感染脑水肿颅内高压症的患病率最高.高渗钠液可用于儿童不同年龄感染性脑水肿颅内高压的治疗,其疗效明显优于甘露醇常规治疗,高渗钠治疗不引起体内钠平衡失调.[Objective]To investigate the effect of hypertonic saline in children with infectious intracranial hypertension（ICH）. [Methods]The treatment methods of decreasing intracranial hypertension of 75 children in our department from 1992 to 2001 were retrospectively analysed. Seventy-five children were divided into routine group （RTG） of 49 and hypertonic saline group （HTSG） of 26. According to the age, 75 cases were divided into 3 groups： ≤1yr （41 cases）, 1-3yrs （18 cases） and 〉3 yrs （16 cases）. [Results]The incidence of ICH was 83. 67% in ≤1yr group, significantly higher than in 1 -3 yrs group （54.55%） or in 〉3yrs group（ 53.33%） （ P 〈0. 01, respectively）. The incidence of improvement of HTSG after 5 days was significantly higher than that of RTG （84.62% vs. 51. 02%, P 〈0.01）. The incidence of treatment failure of HTSG was significantly lower than that of the RTG （ 15.34 % vs. 48.98 %, P 〈0.01 ）. The effects of HTSG treatment in various age groups were similar with no side effect. Blood serum natrium was not significantly different between the two groups. [Conclusion]Hypertonic sodium solution can he used in children of various age with infectious brain edema complicated with intracranial hypertension. The effect of hypertonic sodium solution Hypertonic saline therapy does not cause natrium disequilibrium.

关 键 词：假脑瘤/药物疗法 感染 高渗溶液 钠 

分 类 号：R742.89[医药卫生—神经病学与精神病学]