连续性血液净化治疗重型颅脑外伤并发高钠血症疗效观察  

Clinical observation of the therapeutic effect of continuous blood purification in treatment of hypernatremia in patients with severe head injury

作　　者：李志伟[1] 李超[1] 张睿[1] 梁爱君[1] 马继韬[1] 

机构地区：[1]昆明市第一人民医院ICU,云南昆明650011

出　　处：《中日友好医院学报》2012年第3期151-153,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨连续性血液净化(CBP)治疗重型颅脑外伤并发高钠血症的应用效果。方法:回顾分析32例我院ICU的重型颅脑外伤并发高钠血症患者行CBP治疗的临床资料。治疗中动态监测血清钠以调整置换液钠浓度,观察CBP治疗前后血清钠纠正速度、体温、血流动力学的变化。结果:32例患者心率、体温下降,平均动脉压、氧合指数升高,与治疗前相比,差异均有统计学意义(均P<0.01)。治疗24h后血清钠较治疗前显著下降(147.7±3.5mmol/L vs 165.4±8.5mmol/L,P<0.01)。14例好转(伴意识障碍),3例放弃治疗,15例因并发感染、多脏器功能衰竭最终死亡。结论:CBP治疗能稳定患者内环境,平稳有效地纠正重型颅脑外伤并发高钠血症,安全性好,对重型颅脑外伤并发高钠血症应尽早实施。Objective：To evaluate the therapeutic effect of continuous blood purification（CBP）in treatment of hypernatremia in patients with severe head injury.Methods：Thirty-two patients with severe head injury and concurrent hypernatremia in the intensive care unit were treated with CBP.The sodium concentration in the exchange fluid was adjusted according to the serum sodium concentration.The changes of serum sodium,correcting speed,hemodynamics were observed before and after the treatment.Results：The hypernatremia of the patients significantly declined after the treatment（147.7±3.5mmol/L vs 165.4±8.5mmol/L,P〈0.01）.The therapeutic process was safe.Fourteen patients recovered,3 gave up the treatment and 15 died of multiple organ dysfunction syndrome.Conclusion：CBP is a safe and effective method for the treatment of hypernatremia in patients with severe head injury by stabilizing the patient environment.CBP applied as the early intervention in patients with severe head injury and hypernatremia may get better survival rate.

关 键 词：连续血液净化 高钠血症 重型颅脑外伤 

分 类 号：R651.1[医药卫生—外科学]