高渗钠溶液在闭合性颅脑外伤后颅内压增高中的救治效果  

Prospective study on the efficacy of hypertonic sodium solution in the treatment of increased intracranial pressure after closed craniocerebral trauma

作　　者：封铭恒 郭奕浩 曾昭健 周元君 陈维维 FENG Mingheng;GUO Yihao;ZENG Zhaojian;ZHOU Yuanjun;CHEN Weiwei(Wuzhou Red Cross Hospital,Wuzhou 543000,China)

机构地区：[1]梧州市红十字会医院,广西梧州543000

出　　处：《临床医药实践》2023年第10期730-732,共3页Proceeding of Clinical Medicine

基　　金：广西高校中青年教师科研基础能力提升项目(项目编号:2021KY1961)。

摘　　要：目的:分析闭合性颅脑外伤后颅内压(ICP)增高患者救治过程中应用高渗钠溶液的效果。方法:选择2021年1月—2022年9月接受治疗的闭合性颅脑外伤后颅内压增高患者60例,利用随机数表法分为对照组和观察组,每组30例。对照组给予甘露醇治疗,观察组给予3%高渗钠溶液治疗。比较两组患者的颅内压、平均动脉压(MAP)以及颅内灌注压(CPP)变化情况;比较两组患者预后、伤后6个月病死率以及并发症发生情况。结果:治疗前两组患者的ICP和MAP及CPP比较,差异无统计学意义(P>0.05)。治疗后30 min和60 min两组ICP均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05),而MAP和CPP均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组治疗后3个月、6个月格拉斯哥预后评分表(GCS)评分均明显高于对照组,差异有统计学意义(P<0.05)。观察组伤后6个月病死率和并发症发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论:高渗钠溶液治疗闭合性颅脑外伤后颅内压增高,可以缓解患者脑水肿程度,降低颅内压水平,对改善患者预后具有重要意义。Objective:To analyze the effect of hypertonic sodium solution in the treatment of patients with increased intracranial pressure(ICP)after closed craniocerebral trauma.Methods:The observation objects in this study were all selected from 60 patients with intracranial hypertension after closed craniocerebral trauma who were treated in our hospital from January 2021 to September 2022.The above patients were divided into two groups by using the random number table.The patients treated with mannitol were the control group,and the patients treated with 3%hypertonic sodium solution were the observation group.The changes of intracranial pressure,mean arterial pressure(MAP)and intracranial perfusion pressure(CPP)were compared between the two groups.At the same time,the prognosis,6-month mortality and complications of the two groups were compared.Results:There was no significant difference in ICP,MAP and CPP between the two groups before treatment(P>0.05).ICP was lower in both groups at 30 min and 60 min after treatment than that before treatment,and MAP and CPP were higher in both groups at 30 min and 60 min after treatment than that before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The Glasgow outcome scale(GCS)scores in the observation group were significantly higher than those in the control group at 3 and 6 months after treatment(P<0.05).The mortality and complication rate in the observation group at 6 months after injury were significantly lower than those in the control group(P<0.05).Conclusion:The application of hypertonic sodium solution in the clinical treatment of patients with increased intracranial pressure after closed craniocerebral trauma can relieve the degree of cerebral edema and reduce the level of intracranial pressure,which is of great significance for improving the prognosis of patients.

关 键 词：高渗钠溶液 闭合性颅脑外伤 颅内压增高 预后 

分 类 号：R651.1[医药卫生—外科学]