高渗氯化钠液对重型颅脑损伤患者脑氧代谢的影响  

Impact of hypertonic sodium chloride solution on cerebral oxygen metabolism of patients with severe craniocerebral injury

作　　者：刘杰[1] 李青松[1] 温韬雪[1] 李彦[1] 尚翠翠 Liu Jie;Li Qingsong;Wen Taoxue;Li Yan;Shang Cuicui(Department of Neurosurgery,The Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang,150001,China)

机构地区：[1]哈尔滨医科大学附属第二医院神经外科,哈尔滨150001

出　　处：《西南国防医药》2018年第4期323-326,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的观察不同浓度氯化钠液对重型颅脑损伤患者脑氧代谢的影响。方法将96例重型创伤性颅脑损伤患者随机分为对照组、3%氯化钠组和7.5%氯化钠组,各32例,在治疗后第3、5 d,比较3组血清S-100β、神经元特异性烯醇化酶(NSE)、超氧化物歧化酶(SOD)和丙二醛(MDA)含量,以及血氧饱和度(SjvO_2)、局部脑氧饱和度(rScO_2)和颈内静脉乳酸(DjvLac)水平。结果与治疗后第1 d比较,在治疗后第3、5 d,3组血清S-100β、NSE和MDA含量显著降低(P<0.05),而SOD含量显著升高(P<0.05);而与对照组比较,氯化钠液组各时间点血清S-100β、NSE和MDA含量显著降低(P<0.05),而SOD含量显著升高(P<0.05);与3%氯化钠组比较,7.5%氯化钠组各时间点血清S-100β、NSE和MDA含量显著降低(P<0.05),而SOD含量显著升高(P<0.05)。在治疗后第3、5 d,3组SjvO_2较第1 d显著升高(P<0.05),而DjvLac较第1 d显著降低(P<0.05),但组间比较无显著差异(P>0.05)。结论采用7.5%氯化钠治疗重型颅脑损伤患者,能够有效降低患者血清S-100β、NSE水平,改善脑氧代谢,减轻脑水肿,减少患者继发性脑损伤。Objective To observe the impacts of sodium chloride solutions of different concentrations on cerebral oxygen metabolism of the patients with heavy craniocerebral injury.Methods A total of 96 patients with severe traumatic craniocerebral injury were randomly divided into three groups:the control group,the 3%NaCl group and the high 7.5%NaCl group(n=32,respectively).On the third and fifth day of treatment,the contents of serum S-100β,neuron-specific enolase(NSE),superoxide dismutase(SOD)and malonaldehyde(MDA)as well as the levels of surplus pulse O2(SjvO2),regional oxygen saturation(rScO2)and internal jugular vein lactic acid(DjvLac)were compared.Rults In comparison with the first day of treatment,on the third and fifth days of treatment,the contents of S-100β,NSE and MDA dropped significantly in all groups(P<0.05)while SOD content increased considerably(P<0.05);in comparison with the control group,the contents of S-100β,NSE and MDA dropped significantly in the NaCl groups at all the time nodes(P<0.05)while SOD content increased considerably(P<0.05);in comparison with the 3%NaCl group,the high 7.5%NaCl group showed significantly decreased contents of S-100β,NSE and MDA at the time nodes(P<0.05)while SOD content increased considerably(P<0.05).On the third and fifth days of treatment,SjvO2 level increased greatly in comparison with that in all groups on the first day(P<0.05)while DjvLac level decreased greatly in comparison with that on the first day.No significant differences were found among the groups(P>0.05).Conclusion Treating patients with severe craniocerebral injury with 7.5%NaCl solution can effectively lower serum S-100βand NSE levels,improve cerebral metabolism,relieve cerebral edema and reduce secondary cerebral injury of patients.

关 键 词：高渗 氯化钠液 颅脑 损伤 脑氧代谢 

分 类 号：R651[医药卫生—外科学]