3%高渗盐水不同给药方式治疗重型颅脑损伤的临床研究  

Clinical study on application of 3% hypertonic saline in treatment of severe traumatic brain injury with different administration methods

作　　者：陈涛[1] 全凯[1] 蔡菁[1] 

机构地区：[1]浙江大学医学院附属第二医院,杭州310009

出　　处：《浙江创伤外科》2011年第4期433-436,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省医药卫生科学研究基金(2008A079)

摘　　要：目的探讨3%高渗盐水(HS)不同给药方式治疗重型颅脑损伤的效果及副作用。方法将53例颅脑损伤患者随机分为高渗盐水治疗组(A、B组)和甘露醇治疗组(C组),A组采用静脉单次重复给药,输注剂量为4ml/kgq6h;B组采用静脉持续滴注,维持速度为1ml/kg/h;C组为20%甘露醇125ml静脉快速滴注q6h。监测患者ICP、CVP及第三天电解质和肾功能情况。结果与用药前相比,用药后12小时3组患者的ICP均无统计学差异(P>0.05),而HS组患者中心静脉压在用药后明显升高(P<0.05)。用药后3天A、B组患者血钠、尿素氮、肌酐均无显著改变(P>0.05);C组血尿素氮、肌酐值较同期HS组明显升高(P<0.05)。结论 3%高渗盐水降低颅脑外伤后颅内压效果显著,副作用小,建议使用快速滴注的给药方式。Objective To evaluate the curative and side effects of 3% hypertonic saline （HS） with different injection ways in treatment of sever traumatic brain injury （TBI）. Methods 53 patients with severe TBI were randomly divided into three groups. Group A （16 patients） were treated with venous infusion of 3% HS repeatly （4ml/kg, q6h）. Group B （17 patients） were treated with venous infusion of 3% HS continuously （1ml/kg/h）. Group C （20 patients） were treated with venous infusion of 20% mannitol （125ml）. Intracranial pressure（ICP）, central venous pressure （CVP）, plas- ma electrolyte and renal function were evaluated. Results There were no significant differences in ICP before the treatment and 12 hours after the treatment in each group （P〉0.05）. But the CVP was increased significandy in group A and B （P〈0.05）. There were no significant diferences in plasma sodium, blood urea nitrogen（BUN）, creatinine（Cr） before the treatment and 3 days after the treatment in both group A and B （P〉0.05）. But a significant increase of BUN and Cr were detected 3 days after the treatment in group C （P〈0.05）. Conclusion The application of 3% hypertonic saline with repeatly venous infusion is of good curative effect and few side effects on the patients with severe TBI.

关 键 词：高渗盐水 甘露醇 颅脑损伤 给药方式 

分 类 号：R651.15[医药卫生—外科学]