CAJ | 학술논문

背景高渗溶液是治疗颅内高压(＞20 mmHg)(1 mmHg=0.133 kPa)的有效手段.甘露醇和高渗盐水为临床上常用的两种降颅压高渗溶液.目前临床上选择这两种液体治疗颅内高压存在争议. 目的促进人们深入理解高渗溶液对颅内高压的影响. 内容对这两种高渗溶液的作用特点、机制、临床应用及副作用等方面的研究进展作一综述.最近发表的荟萃分析未能明确哪种高渗液体在处理颅内高压和增加脑灌注压方面更佳,但在高渗治疗时维持血浆渗透压＜320mOsm/L和血钠水平在145mmol/L～155mmol/L是合适的. 趋向研究不同高渗液体的适应症、应用时机、最佳剂量,有助于颅内高压患者的临床处理.
배경 고삼용액시치료로내고압(＞20 mmHg)(1 mmHg=0.133 kPa)적유효수단.감로순화고삼염수위림상상상용적량충강로압고삼용액.목전림상상선택저량충액체치료로내고압존재쟁의. 목적 촉진인문심입리해고삼용액대로내고압적영향. 내용 대저량충고삼용액적작용특점、궤제、림상응용급부작용등방면적연구진전작일종술.최근발표적회췌분석미능명학나충고삼액체재처리로내고압화증가뇌관주압방면경가,단재고삼치료시유지혈장삼투압＜320mOsm/L화혈납수평재145mmol/L～155mmol/L시합괄적. 추향 연구불동고삼액체적괄응증、응용시궤、최가제량,유조우로내고압환자적림상처리.
Background The hyperosmolar solutions are an effective therapy for raised intracranial pressure(＞20 mmHg)(1 mmHg=0.133 kPa).The two commonly used hyperosmolar solutions are mannitoli and hypertonic saline in clinical practice.However,there is controversy on how to select hyperosmolar solutions to manage raised intracranial pressure.Objective To promote people to deeply understand the effect of hyperosmolar solutions on the raised intracranial pressure.Content In this paper the pharmacologic mechanisms,clinical applications and adverse effects of the two hyperosmolar solutions in recent researches are reviewed.Recent published meta-analysis failed to confirm which hyperosmolar solution is better in management of intracranial hypertension and cerebral perfusion pressure,however,maintaining plasma osmolality ＜320 mOsm/L and sodium level between 145 mmol/L-155 mmol/L is appropriate during hyperosmolar therapy.Trend The studies on indications,timing and optimal dose of those hyperosmolar solutions will be helpful in clinical management of patients with intracranial hypertension.