【摘要】 目的探讨7.5%高渗盐水治疗重型颅脑损伤的效果及副作用。方法将50例颅脑损伤患者随机分为高渗盐水治疗组(HTS组,26例)和甘露醇治疗组(M组,24例)。HTS组静脉滴注7.5%高渗盐水2 ml/kg,M组静脉滴注甘露醇250 ml,均为q8h,连续7 d。用药前及用药后第1、3、7天测患者血电解质、渗透压和肾功能,用药前及用药后2周对患者进行GCS评分。结果与用药前相比,用药后6 h两组患者的平均动脉压、心率、呼吸均无统计学差异(P>0.05),而HTS组患者中心静脉压在用药后明显升高(P<0.05)。用药后第1、3、7天HTS组患者血K+、Na+、Cl-、尿素氮、肌酐及血浆渗透压均无显著改变;M组血K+、Na+、Cl-、肌酐及血浆渗透压无显著改变(P>0.05),但用药后第7天尿素氮值较同期HTS组明显升高(P<0.05)。用药2周后,两组患者GCS评分均有明显改善(P<0.05)。结论7.5%高渗盐水降低颅脑损伤引起的高颅内压是安全、有效的,连续使用效果好、副作用少。更多还原

【Abstract】 Objective To evaluate the curative and side effects of 7.5% hypertonic saline on patients with severe craniocerebral injury.Methods Fifty patients with severe craniocerebral injury were randomly divided into two groups,i.e.hypertonic saline solution(HTS) group(26 patients),where the patients were treated by venous infusion of 7.5% HTS,and mannitol group,where the patients were treated by venous infusion of 20% mannitol(24 patients).Plasma electrolytes,plasma osmotic pressure(POP) and renal function were evaluated before the treatment and 1,3 and 7 days after the treatment.In addition,Glasgow Coma Scale(GCS) was evaluated before the treatment and 14 days after the treatment.Results There were insignificant differences in plasma K+,Na+,Cl-,blood urea nitrogen(BUN),creatinine(Cr) and POP between before the treatment and 1 or 3 or 7 days after the treatment in HTS group.The insignificant increases in BUN and Cr were detected 1,3 and 7 days after the treatment in mannitol compared to before the treatment,but the concentration of BUN was significantly higher in mannitol group than that in HTS group 7 days after the treatment(P<0.05).GCS was significantly improved 14 days after the treatment in both HTS and mannitol groups(P<0.05).Conclusions The hypertonic(7.5%) saline solution is of good curative effect and few side effect on the patients with severe craniocerebral injury.It can be safely and continually used in the patients with intracranial hypertension induced by craniocerebral injury.更多还原