3%高渗盐水对重型颅脑损伤患者颅内压和脑组织氧分压的影响  

Effects of 3% hypertonic saline on intracranial pressure and partial oxygen pressure of brain tissue in patients with severe brain injury

作　　者：王其平[1] 徐裕[1] 那汉荣[1] 高恒[1] 

机构地区：[1]江阴市人民医院神经外科,江苏省214400

出　　处：《江苏医药》2015年第22期2688-2690,共3页Jiangsu Medical Journal

基　　金：无锡市科技发展指导计划项目(CSZ00966)

摘　　要：目的比较3%高渗盐水(HTS)与20%甘露醇(MT)渗透性脱水治疗重型颅脑损伤对颅内压(ICP)和脑组织氧分压(PbtO2)的影响。方法重型颅脑损伤患者35例随机分为两组,分别接受HTS 130ml(HTS组,18例)和MT 130ml(MT组,17例)治疗,均于20min内一次静脉输注。记录两组治疗后30、60、120和180min的ICP、MAP、脑灌注压(CPP)、PbtO2和CVP。结果治疗后,两组均显示ICP降低和CPP升高(P<0.05);HTS组的变化较MT组更加明显,且同时有PbtO2升高(P<0.05)。结论与20%MT相比,3%HTS能更好地降低ICP和增加CPP,同时还能升高PbtO2。Objective To compare the effects of 3% hypertonic saline（HTS）as osmotic dehydration therapy on intracranial pressure（ICP）and partial oxygen pressure of brain tissue（PbtO2）in the patients with severe brain injury.Methods Thirty-five patients with severe brain injury were randomly treated with 3% HTS（group A,18cases）or 20% mannitol（group B,17cases）,which were infused intravenously within 20 min.The ICP,MAP,cerebral perfusion pressure（CPP）,PbtO2 and CVP were recorded at 30,60,120 and 180min after infusion.Results Compared to before,the ICP was reduced and CPP was increased after treatment in both groups（P〈0.05）,which were more in group A than those in group B（P〈0.05）.The PbtO2 in group A was elevated after treatment compared to before（P〈0.05）,which in group B was not significantly changed（P〉0.05）.Conclusion 3% HTS is better than 20% mannitol in reducing ICP,increasing CPP and elevating PbtO2 in the patients with severe brain injury.

关 键 词：颅脑损伤 渗透性脱水治疗 高渗盐水 甘露醇 

分 类 号：R651[医药卫生—外科学]