托拉塞米与极化液联合治疗重症颅脑外伤所致颅内高压的价值  

The Value of Torasemide Combined With GIK In The Treatment of Intracranial Hypertension Caused by Severe Craniocerebral Trauma

作　　者：张明 尚云[1] 王扬名 Zhang Ming;Shang Yun;Wang Yangming(Emergency Department,First People's Hospital of Xinxiang City,Xinxiang 453000,Henan,China)

机构地区：[1]新乡市第一人民医院急诊科,河南新乡453000

出　　处：《哈尔滨医药》2023年第4期9-12,共4页Harbin Medical Journal

摘　　要：目的 观察托拉塞米联合极化液(GIK)治疗重症颅脑外伤所致颅内高压的价值。方法 回顾性分析142例重症颅脑外伤致颅内高压患者的临床资料,根据用药方案将其分为对照组与观察组。对照组67例,采用托拉塞米治疗;观察组75例,采用托拉塞米联合GIK治疗。比较两组治疗后格拉斯哥预后(GOS)评分;治疗前及治疗30min、1h、2h后颅内压(ICP)情况;比较两组治疗前后中心静脉压(CVP)、平均动脉压(MAP)、脑灌注压(CPP)水平与氧化应激指标[总抗氧化能力(total antioxidant capacity)、超氧化物歧化酶(SOD)、丙二醛(MDA)];对比两组治疗后药物不良反应发生率。结果 治疗后,观察组GOS评分明显高于对照组(P<0.05);两组ICP均显著降低,观察组明显低于对照组(P<0.05);两组MDA水平显著降低,观察组高于对照组(P<0.05);两组CVP、CPP、T-Aoc与SOD水平均显著增加,观察组明显高于对照组(P<0.05);治疗前后MAP水平及两组药物不良反应发生率差异无统计学意义(P>0.05)。结论 托拉塞米与GIK联合治疗重症颅脑外伤所致颅内高压疗效确切,可有效控制颅内高压症状,减少氧化应激,从而改善患者预后,有较高推广应用价值。Objective To observe the value of torasemide combined with GIK in the treatment of intracranial hypertension caused by severe craniocerebral trauma.Methods The clinical data of 142 patients with intracranial hypertension caused by severe craniocerebral trauma treated were retrospectively analyzed,and they were divided into control group and observation group according to the medication regimen.67 cases in the control group were treated with torasemide;75 cases in the observation group were treated with torasemide combined with GIK.The GOS scores of the two groups after treatment were compared.The intracranial pressure(ICP)before treatment,30min,1h and 2h after treatment were compared.The levels of CVP,MAP,CPP and oxidative stress indexes(T-AOC,SOD,MDA)were compared between the two groups before and after treatment.The incidence of adverse drug reactions after treatment was compared between the two groups.Results After treatment,the GOS score of the observation group was significantly higher than that of the control group(P<0.05).ICP decreased significantly in both groups,and the observation group was significantly lower than the control group(P<0.05).The MDA level of the two groups decreased significantly,and the observation group was higher than that of the control group(P<0.05).The levels of CVP,CPP,T-AOC and SOD were significantly increased in both groups,and the observation group was significantly higher than the control group(P<0.05).There was no significant difference in MAP level and the incidence of adverse drug reactions between the two groups before and after treatment(P>0.05).Conclusions Torasemide combined with GIK is effective in the treatment of intracranial hypertension caused by severe craniocerebral trauma.It can effectively control the symptoms of intracranial hypertension,reduce oxidative stress,and improve the prognosis of patients.It has high popularization and application value.

关 键 词：托拉塞米 极化液 重症颅脑外伤 颅内高压 

分 类 号：R651.15[医药卫生—外科学]