中国实用神经疾病杂志
中國實用神經疾病雜誌
중국실용신경질병잡지
CHINESE JOURNAL OF PRACTICAL NERVOUS DISEASES
2014年
6期
14-15
,共2页
重症颅脑损伤%颅内压监护%高渗盐水
重癥顱腦損傷%顱內壓鑑護%高滲鹽水
중증로뇌손상%로내압감호%고삼염수
Severe craniocerebral injury%Intracranial pressure monitoring%Hypertonic saline
目的：探讨颅内压监测结合高渗盐水降低颅内压对重症颅脑损伤的临床效果。方法将95例重症颅脑损伤患者随机分为3组，常规治疗组30例采用常规20％甘露醇脱水治疗，未进行颅内压检测；颅内压监护＋常规治疗组（监护＋常规治疗组）30例，入院给予颅内压检测及常规治疗；颅内压监护＋高渗盐水治疗组（监护＋高渗治疗组）35例，入院给予颅内压检测，并及时采用3％高渗盐水降低颅内压。结果监护＋常规治疗组与常规治疗组疗效比较无显著性差异（ P＞0.05）；监护＋高渗治疗组与监护＋常规治疗组和常规治疗组的疗效比较均有显著性差异（ P＜0.05）；常规组并发症发生率较高，监护＋高渗治疗组及监护＋常规治疗组的并发症均明显少于常规组（ P＜0.05）；监护＋常规治疗组和监护＋高渗治疗组中，颅内压＜20 mmHg组、20～30 mmHg组、＞30～40 mmHg组间预后比较，均有显著性差异（P＜0.05）。结论颅内压监护结合高渗盐水能有效监控重症颅脑损伤患者的颅内压变化，临床效果满意，值得进一步推广。
目的：探討顱內壓鑑測結閤高滲鹽水降低顱內壓對重癥顱腦損傷的臨床效果。方法將95例重癥顱腦損傷患者隨機分為3組，常規治療組30例採用常規20％甘露醇脫水治療，未進行顱內壓檢測；顱內壓鑑護＋常規治療組（鑑護＋常規治療組）30例，入院給予顱內壓檢測及常規治療；顱內壓鑑護＋高滲鹽水治療組（鑑護＋高滲治療組）35例，入院給予顱內壓檢測，併及時採用3％高滲鹽水降低顱內壓。結果鑑護＋常規治療組與常規治療組療效比較無顯著性差異（ P＞0.05）；鑑護＋高滲治療組與鑑護＋常規治療組和常規治療組的療效比較均有顯著性差異（ P＜0.05）；常規組併髮癥髮生率較高，鑑護＋高滲治療組及鑑護＋常規治療組的併髮癥均明顯少于常規組（ P＜0.05）；鑑護＋常規治療組和鑑護＋高滲治療組中，顱內壓＜20 mmHg組、20～30 mmHg組、＞30～40 mmHg組間預後比較，均有顯著性差異（P＜0.05）。結論顱內壓鑑護結閤高滲鹽水能有效鑑控重癥顱腦損傷患者的顱內壓變化，臨床效果滿意，值得進一步推廣。
목적：탐토로내압감측결합고삼염수강저로내압대중증로뇌손상적림상효과。방법장95례중증로뇌손상환자수궤분위3조，상규치료조30례채용상규20％감로순탈수치료，미진행로내압검측；로내압감호＋상규치료조（감호＋상규치료조）30례，입원급여로내압검측급상규치료；로내압감호＋고삼염수치료조（감호＋고삼치료조）35례，입원급여로내압검측，병급시채용3％고삼염수강저로내압。결과감호＋상규치료조여상규치료조료효비교무현저성차이（ P＞0.05）；감호＋고삼치료조여감호＋상규치료조화상규치료조적료효비교균유현저성차이（ P＜0.05）；상규조병발증발생솔교고，감호＋고삼치료조급감호＋상규치료조적병발증균명현소우상규조（ P＜0.05）；감호＋상규치료조화감호＋고삼치료조중，로내압＜20 mmHg조、20～30 mmHg조、＞30～40 mmHg조간예후비교，균유현저성차이（P＜0.05）。결론로내압감호결합고삼염수능유효감공중증로뇌손상환자적로내압변화，림상효과만의，치득진일보추엄。
Objective To study the clinical efficacy of intracranial pressure monitoring combined with depressing intracra-nial pressure by hypertonic saline on severe craniocerebral injury.Methods 95 cases with severe craniocerebral injury were di-vided into three groups :30 cases as conventional therapy group (CT group) ,who were given 20% mannitol dehydrating with-out intracranial pressure monitoring ;30 cases as intracranial pressure monitoring + conventional therapy group (ICPM + CT group) ,who were given intracranial pressure monitoring and 20% mannitol dehydrating ;35 cases as intracranial pressure mo-nitoring+depressing intracranial pressure by hypertonic saline groups (ICPM+ HS group) ,which were given intracranial pres-sure monitoring and 3% hypertonic saline after admission.Results There were no significant difference between CT group and ICPM+ CT group (P>0.05);the clinical efficacy were better in ICPM + HS group than CT group or ICPM+ CT group ,and there was significant difference among ICPM + HS group and CT group or ICPM+ CT group ;there were more less of compli-cation in ICPM+ HS group and ICPM + CT group than CT group(P< 0.05). Among ICPM + HS group and ICPM + CT group ,there were signicantly difference on prognosis among ICP less 20 mmHg ,20-30 mmHg ,and 30-40 mmHg(P<0.05).Conclusion ICPM+ HS could monitor the change of ICP in patients with severe craniocerebral injury ,and depress the ICP in time ,which has better clinical efficacy and is worth of further spreading.
