高渗盐水与甘露醇交替使用治疗重型颅脑损伤术后颅内高压临床分析.docVIP

高渗盐水与甘露醇交替使用治疗重型颅脑损伤术后颅内高压临床分析 　　[摘要] 目的 探索高渗盐水与甘露醇交替使用治疗重型颅脑损伤术后颅内高压的效果和安全性。 方法 选择2011年1月～2013年6月本院收治的重型颅脑损伤术后颅内高压患者120例，随机分为观察组（3%高渗盐水与20%甘露醇交替使用）、高渗盐水组（单独使用3%高渗盐水）和甘露醇组（单独使用20%甘露醇），观察三组患者治疗3 d后颅内压、血清肌酐及血钠水平的变化。 结果 观察组患者治疗3 d后颅内压明显低于高渗盐水组和甘露醇组（P0.05），血钠水平明显低于高渗盐水组（P0.05），血清肌酐水平明显低于甘露醇组（P0.05）。 结论 高渗盐水与甘露醇交替使用能有效降低重型颅脑损伤术后颅内高压水平，并且能降低肾功能不全和电解质平衡紊乱的发生率。 　　[关键词] 高渗盐水；甘露醇；交替使用；重型颅脑损伤；颅内高压 　　[中图分类号] R651.1+5 [文献标识码] A [文章编号] 1674-4721（2013）11（a）-0082-02 　　Clinical analysis of alternate use of hypertonic saline and mannitol in treatment of postoperative intracranial hypertension in severe traumatic brain injury 　　TAN Xin ZHANG Zong-ping CHEN Chun-yan WU Xiao-hua 　　Department of Neurosurgery，Agribusiness Central Hospital of Zhanjiang City in Guangdong Province，Zhanjiang 524002，China 　　[Abstract] Objective To explore the efficacy and safety of the alternate use of hypertonic saline and mannitol in the treatment of postoperative intracranial hypertension in severe traumatic brain injury. Methods 120 cases of postoperative intracranial hypertension in severe traumatic brain injury treated in our hospital from January 2011 to June 2013 were selected and randomly divided into observation group（alternate use of 3% hypertonic saline and 20% mannitol），hypertonic saline group（3% hypertonic saline alone） and mannitol group（20% mannitol alone）.3 days after treamtment，intracranial pressure，serum creatinine and serum sodium were compared. Results Intracranial pressure of patients in the observation group 3 days after treatment was significantly lower than that in the hypertonic saline group and mannitol group（P0.05）；serum sodium level of the observation group was significantly lower than that of the hypertonic saline group（P0.05）；serum creatinine level of the observation group was significantly lower than that of the mannitol group（P0.05）. Conclusion Altenate use of hypertonic saline and mannitol can effectively reduce intracranial pressure in severe traumatic brain injury an