短期应用高渗盐水对重症蛛网膜下腔出血患者颅内压、脑血流量的影响  

Effect of short-term use of hypertonic saline on intracranial pressure, cerebral blood flow in poor-grade patients with subarachnoid hemorrhage while using hypertonic saline for short-term

作　　者：杨云娜[1] 顾征[1] 李彤[1] 马向科[1] 杨海波[1] 

机构地区：[1]首都医科大学附属北京朝阳医院(京西区)神经外科,北京100043

出　　处：《国际外科学杂志》2010年第11期745-747,共3页International Journal of Surgery

摘　　要：目的探讨23．4％高渗盐水（HTS）对重症蛛网膜下腔出血（SAH）患者颅内压、脑灌注压、脑血流量（CBF）的影响。方法16例重症SAH患者（GCS≤8分）在颅压升高时接受静脉输注23．4％HTS，监测用药前及用药后30、60、90、120、150、180min的颅内压（ICP），平均动脉压（MAP），脑灌注压（CPP）及脑血流速度（FV）。结果用药后30min可见ICP显著降低，同时MAP、CPP及FV显著升高（P〈0．05），ICP显著降低可持续180min，CPP和FV的改善持续约90min（P〈0．05）。结论HTS能显著降低重症SAH患者的ICP，改善脑组织灌注，可用来纠正脑缺血引恕的病牛王单蛮化．Objective To investigate the effect of 23.4% hypertonic saline （HTS）on intraeranial pressure（ICP） , cerebral perfusion pressure（CPP） , cerebral blood flow （CBF）in poor-grade patients with subarachnoid hemorrhage （SAH）. Methods Sixteen patients （ Glasgow coma score ≤ 8 ） with poor-grade SAH received 23.4% hypertonic saline intravenously for elevated ICP. ICP, mean arterial pressure（ MAP）, CPP and the middle cerebral artery flow velocity （ FV ） were observed and recorded before and at 30, 60, 90, 120, 150, 180 rain after the injection respectively. Results Thirty minutes postinfusion, a significant increase in MAP, CPP, FV was seen together with a decrease in ICP （ P 〈 0.05 ）. ICP remained reduced for 180 minutes, CPP and FV remained elevated for 90 minutes （ P 〈 0.05 ）. Conclusions HTS can significantly decrease ICP and improve CBF in patients with poor-grade subarachnoid hemorrhage and may be used for reversal of pathophysiologic changes caused by cerebral ischemia.

关 键 词：蛛网膜下腔出血 高渗盐水 颅内压 脑血流量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]