颅脑损伤患者急诊手术中输注聚明胶肽的临床观察  

Efficacy of polygeline infusion on TBI patients in emergency surgery

作　　者：杨玺[1] 梁涛[1] 温开兰[1] 

机构地区：[1]四川省人民医院麻醉科,成都610072

出　　处：《西南国防医药》2016年第11期1251-1253,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨平衡液与联合使用胶体液对急诊手术创伤性颅脑损伤患者的救治效果。方法将在我院就诊的90例创伤性颅脑损伤患者随机分为H组和E组,患者入室后常规全麻诱导插管,E组单纯输注平衡液,H组按照1∶1比例输注平衡液和聚明胶肽,观察两组手术中液体输注量、输注红细胞悬液和升压药的使用情况,以及术后神经外科重症监护病房(NICU)的停留时间,术后第1、3、7、14 d的格拉斯哥评分(GCS)等指标。结果术后第1、3 d,两组GCS变化的差异无统计学意义(P>0.05);第7 d、14 d,H组GCS评分高于E组(P<0.05)。H组显著减少了术中红细胞悬液的输注量和血管活性药物的使用,NICU的停留时间也短于E组(P<0.05)。结论平衡液与聚明胶肽联合使用可显著减少血管活性药物和血制品的使用(P<0.05),也更有利于患者愈后。Objective To explore the efficacy of equilibrium liquid combined with colloidal solution on traumatic brain injury（TBI） patients in emergency surgery. Methods A total of 90 TBI patients admitted to our hospital were selected and randomly divided into groups H and E. General anesthesia induction intubation was applied to such patients after they were sent into the operation room. Group E was injected with equilibrium liquid only, while group H was injected with equilibrium liquid and polygeline in the proportion of 1∶1 in order to observe the liquid infusion volume, infusion of red blood cell suspension and the application of pressor agent, the LOS in NICU, the GCS on the first, third, seventh and 14 th day and other indexes. Results There was no significant difference in the GCS changes on the first and third days between the two groups（P〉0.05）; however, the GCS on the seventh and14 th day in group H was higher than that in group E（P〈0.05）. The amount of erythrocyte suspension infusion and vascular active drugs was significantly reduced in group H during operation（P〈0.05）. The LOS in NICU in group H was also shorter than that in group E（P〈0.05）. Conclusion The combination of equilibrium liquid and polygeline can significantly reduce the amount of vasoactive drugs and less blood products, and is more beneficial to patient prognosis.

关 键 词：颅脑损伤 聚明胶肽 液体治疗 格拉斯哥昏迷评分 

分 类 号：R651.15[医药卫生—外科学]