高氧液静脉输注救治重型颅脑损伤的临床研究  

Clinical Study of Oxygen-enriched Liquid by Infusion on Patients with Severe Brain Trauma

作　　者：时兢[1] 戴幼竹[1] 胡纪根[1] 陆荣国[1] 衡军锋[1] 许红阳[1] 严正[1] 蔡亚萍[1] 周淑芳[1] 

机构地区：[1]南京医科大学附属无锡市第一人民医院急诊科,无锡214002

出　　处：《临床急诊杂志》2005年第6期9-10,28,共3页Journal of Clinical Emergency

摘　　要：目的探讨静脉输注高氧液对重型颅脑损伤患者的治疗作用。方法选择重型颅脑损伤患者108例,随机分为治疗组(常规治疗加静脉输氧)和对照组(仅常规治疗),每组54例。两组均采用脱水、手术、止血、输血等常规治疗。对照组输入5%GS 10～20 ml/kg,治疗组输入等量的高氧液。观察每位患者的生命体征、颅内压或脑脊液静水压、血气指标、脑水肿程度,记录入院第7d GCS 和3个月后 GOS,井进行组间比较。结果治疗组静脉输注高氧液3 h,患者 PaO_2和 SaO_2水平明显高于输液前(P<0.01)。治疗组患者生命体征比较稳定;伤后1周内治疗组患者颅内压较低(P<0.01);第7 d 治疗组重度脑水肿的发生率明显减少(P<0.01);治疗组患者1周后意识转清率(GCS)明显高于对照组(P<0.05);伤后3个月 GOS 治疗组显著高于对照组(P<0.01)。结论静脉输注高氧液是对重型颅脑损伤患者有效的治疗方法之一。Objective To investigate the curative effect of oxygen-enriehed liquid by infusion of on patients with severe brain trauma. Methods One hundred and eight patients with severe brain trauma were randomly divided into two groups：the experimental gruup treated by oxygen-enriched liquid plus routine treatment（ n = 54） and the cuntrol group treated only by routine treatment （ n = 54）. The same measures such as srugical operation.hemostasis and transfusion were used in two groups. 5% GS 10 - 20 ml/kg was applied in the control group and oxygen-enriched liquid 10 - 20 ml/kg injected in the experimental group. The physical signs of life,intraeranial pressure or cerebrospinal fluid pressure,blood-gas markers and the severity of cerebral edema were also observed ,and consciousness rate（GCS） recorded 7 days after admission and GOS recorded three months later and comparison perfunned. Results PaO2, and SaO2 improved significantly quicker after treating by oxygen-enriched liquid in experimental gmup than those in control group （ P 〈 0.01 ）. The physical signs of life ,were much smooth in experimental group than those in control group. In 7 days after operation ,the ICP was lower in experimental group than that in comtrol group（ P 〈 0.01 ）. On seventh clay the incidence rate of severe cerebral edema reduced significantly（ P 〈 0.01 ）. The duration fmm coma to GCS affer first week and GOS after 3 month in experiment group were higher than those in control group respectively（ P 〈0. 05 - 0.01 ）. Conclusion Oxygen-enriched liquid by iafusion may be an effective measure in patients with severe brain trauma.

关 键 词：重型颅脑损伤 高氧液 静脉输注 救治 

分 类 号：R651.15[医药卫生—外科学]