阶梯性脱水药物对老年人脑挫裂伤的应用价值  

作　　者：张宏图[1] 

机构地区：[1]山东省菏泽市立医院神经外科,274031

出　　处：《中国综合临床》2013年第2期195-197,共3页Clinical Medicine of China

摘　　要：目的探讨阶梯性应用脱水药物治疗老年人脑挫裂伤对减少迟发性外伤性颅内血肿、提高神经功能恢复的优势。方法符合标准的120例患者按随机原则分为阶梯性脱水药物治疗组（60例，A组），常规应用脱水药物治疗组（60例，B组）。阶梯性脱水药物治疗组根据脑水肿发展规律，早期减少脱水药物用量，随着脑水肿发展，阶梯性增加脱水药物用量；常规应用脱水药物治疗组则常规量应用脱水药物。对比两组患者迟发性外伤性颅内血肿发生率及脑挫裂伤治愈率。结果阶梯性脱水药物治疗组迟发性外伤性颅内血肿发生率为8％（5／60），常规应用脱水药物治疗组为30％（18／60），阶梯性脱水药物治疗组明显低于常规应用脱水药物治疗组，两组间差异有统计学意义（X。=6．21，P〈0．05）；阶梯性脱水药物治疗组恢复良好率为70％（42／60），常规应用脱水药物治疗组为30％（28／60），阶梯性脱水药物治疗组明显高于常规应用脱水药物治疗组，两组间差异有统计学意义（）（2=6．72，P〈0．05）。结论随着脑水肿的发展过程阶梯性应用脱水药物治疗老年人脑挫裂伤是比较合理的治疗方案，较常规应用脱水药物治疗明显降低迟发性外伤性颅内血肿的发生率，预后良好。Objective To explore the advantage of stepwise therapy of dehydration drugs on aged people with cerebral contusion for reduce the incidence of delayed traumatic intracranial hematoma and improve neurological function.Methods One hundred and twenty standard patients were divided into stepwise therapy group(n =60,group A) and regular therapy group(n =60,group B) by randomly.In group A,according to the developing regularity of cerebral edema,we use less dehydration drugs on early stage,and increase the dose step by step with the disease developed.In group B,we use dehydration drugs regularly,then compare the incidence rate of delayed traumatic intracranial hematoma and the cure rate of the disease between this two groups.Results The incidence of delayed traumatic intracranial hematoma was 8％ (5/60) in A group,and 30％ (18/60) in B group.Compared with B group,the stepwise therapy of dehydration drugs on cerebral contusion can reduce the incidence of delayed traumatic intracranial hematoma obviously,there was significant difference between two groups(x2 =6.21,P ＜0.05) ;The recovering rate was 70％ (42/60) in B group,and 30％ (28/60) in B group,there was significant difference between two groups (x2 =6.72,P ＜ 0.05).Conclusion The treatment of stepwise therapy is more reasonable on aged people with cerebral contusion,the incidence of delayed traumatic intracranial hematoma can be reduced obviously compared with regular therapy of dehydration drugs.

关 键 词：阶梯性脱水药物 脑挫裂伤 老年人 

分 类 号：R651.15[医药卫生—外科学]