托拉塞米联合3%高渗盐水治疗重症颅脑外伤致颅内高压的临床效果  

Clinical effect of torasemide combined with 3%hypertonic saline in the treatment of intracranial hypertension caused by severe craniocerebral injury

作　　者：张涛[1] 郭旗 ZHANG Tao;GUO Qi(Sun Si Miao Hospital of BUCM/Traditional Chinese Medicine Hospital of Tongchuan,Tongchuan 727000,China)

机构地区：[1]北京中医药大学孙思邈医院/铜川市中医医院,陕西铜川727000

出　　处：《临床医学研究与实践》2023年第14期9-12,共4页Clinical Research and Practice

摘　　要：目的探讨托拉塞米联合3%高渗盐水治疗重症颅脑外伤致颅内高压的临床效果。方法选取2020年1月至2021年1月收治的100例重症颅脑外伤致颅内高压患者作为研究对象,按照随机数字表法将其分为对照组(50例,3%高渗盐水)和观察组(50例,托拉塞米联合3%高渗盐水)。比较两组的颅内压、心率、中心静脉压、脑灌注压、血液流变学指标、氧化应激指标、神经功能缺损情况及日常生活能力。结果治疗后6 h及治疗后1、3、5 d,观察组的颅内压低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的心率低于对照组,脑灌注压高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的全血黏度(WBV)、红细胞沉降率(ESR)、红细胞比容(HCT)低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC)水平高于对照组,丙二醛(MDA)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,日常生活能力量表(ADL)评分高于对照组,差异具有统计学意义(P<0.05)。结论托拉塞米联合3%高渗盐水治疗重症颅脑外伤致颅内高压可有效降低颅内压,调节血液流变学,改善神经功能,提高日常生活能力,值得临床推广和应用。Objective To explore the clinical effect of torasemide combined with 3%hypertonic saline in the treatment of intracranial hypertension caused by severe craniocerebral injury.Methods A total of 100 patients with intracranial hypertension caused by severe craniocerebral injury admitted from January 2020 to January 2021 were selected as the study subjects.The patients were divided into control group(50 cases,3%hypertonic saline)and observation group(50 cases,torasemide combined with 3%hypertonic saline)according to random number table method.The intracranial pressure,heart rate,central venous pressure,cerebral perfusion pressure,hemorheology indexes,oxidative stress indexes,neurological deficit and ability of daily living were compared between the two groups.Results The intracranial pressure of the observation group was lower than that of the control group at 6 h after treatment and at 1,3 and 5 d after treatment,and the difference was statistically significant(P<0.05).After treatment,the heart rate of the observation group was lower than that of the control group,the cerebral perfusion pressure was higher than that of the control group,and the differences were statistically significant(P<0.05).After treatment,the whole blood viscosity(WBV),erythrocyte sedimentation rate(ESR)and hematocrit(HCT)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of superoxide dismutase(SOD)and total antioxidant capacity(T-AOC)in the observation group were higher than those in the control group,the level of malonaldehyde(MDA)was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the National Institutes of Health Stroke Scale(NIHSS)score of the observation group was lower than that of the control group,the Activity of Daily Living Scale(ADL)score was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Torasemide combined

关 键 词：重症颅脑外伤 颅内高压 托拉塞米 3%高渗盐水 血液流变学 氧化应激 日常生活能力 

分 类 号：R651[医药卫生—外科学]