安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2015年
8期
960-962,963
,共4页
高钠血症%鼻饲%米汤%清水%脑损伤,急性
高鈉血癥%鼻飼%米湯%清水%腦損傷,急性
고납혈증%비사%미탕%청수%뇌손상,급성
Hypernatremia%Nasogastric gavage%Rice water%Pure water%Brain injury,Acute
目的：分别通过米汤、清水鼻饲和静脉输液治疗急性脑损伤高钠血症，比较3种方法纠正重症高钠血症的临床效果。方法收集44例急性脑损伤的高钠血症患者，分为米汤鼻饲治疗组18例，清水鼻饲治疗组15例，静脉输液对照组11例。比较3组患者出现高钠血症的血钠水平、血钠恢复正常所需时间、肠鸣音恢复所需时间、胃内容物隐血、病死率及米汤和清水鼻饲并发症情况。结果米汤组血钠恢复所需时间（88.11±7.14）h，与清水组血钠恢复时间（93.07±8.09）h 比较差异无统计学意义（P ﹥0.05），但都短于对照组（179.36±13.51）h（P ﹤0.05）；米汤组的肠鸣音恢复时间（32.17±5.78）h 短于清水组（90.00±7.93）及对照组（384.91±35.71）h（P 均﹤0.05）；对于胃内容物隐血的发生，清水组多于米汤组，但都少于对照组（P ﹤0.05）；米汤组鼻饲的并发症少于清水组（P ﹤0.05），对照组的病死率均高于米汤组和清水组（P ﹤0.05）。结论鼻饲是一种简便、安全的纠正高钠血症的治疗方法，使用米汤鼻饲能使患者肠功能较快恢复，且并发症少，值得临床推广应用。
目的：分彆通過米湯、清水鼻飼和靜脈輸液治療急性腦損傷高鈉血癥，比較3種方法糾正重癥高鈉血癥的臨床效果。方法收集44例急性腦損傷的高鈉血癥患者，分為米湯鼻飼治療組18例，清水鼻飼治療組15例，靜脈輸液對照組11例。比較3組患者齣現高鈉血癥的血鈉水平、血鈉恢複正常所需時間、腸鳴音恢複所需時間、胃內容物隱血、病死率及米湯和清水鼻飼併髮癥情況。結果米湯組血鈉恢複所需時間（88.11±7.14）h，與清水組血鈉恢複時間（93.07±8.09）h 比較差異無統計學意義（P ﹥0.05），但都短于對照組（179.36±13.51）h（P ﹤0.05）；米湯組的腸鳴音恢複時間（32.17±5.78）h 短于清水組（90.00±7.93）及對照組（384.91±35.71）h（P 均﹤0.05）；對于胃內容物隱血的髮生，清水組多于米湯組，但都少于對照組（P ﹤0.05）；米湯組鼻飼的併髮癥少于清水組（P ﹤0.05），對照組的病死率均高于米湯組和清水組（P ﹤0.05）。結論鼻飼是一種簡便、安全的糾正高鈉血癥的治療方法，使用米湯鼻飼能使患者腸功能較快恢複，且併髮癥少，值得臨床推廣應用。
목적：분별통과미탕、청수비사화정맥수액치료급성뇌손상고납혈증，비교3충방법규정중증고납혈증적림상효과。방법수집44례급성뇌손상적고납혈증환자，분위미탕비사치료조18례，청수비사치료조15례，정맥수액대조조11례。비교3조환자출현고납혈증적혈납수평、혈납회복정상소수시간、장명음회복소수시간、위내용물은혈、병사솔급미탕화청수비사병발증정황。결과미탕조혈납회복소수시간（88.11±7.14）h，여청수조혈납회복시간（93.07±8.09）h 비교차이무통계학의의（P ﹥0.05），단도단우대조조（179.36±13.51）h（P ﹤0.05）；미탕조적장명음회복시간（32.17±5.78）h 단우청수조（90.00±7.93）급대조조（384.91±35.71）h（P 균﹤0.05）；대우위내용물은혈적발생，청수조다우미탕조，단도소우대조조（P ﹤0.05）；미탕조비사적병발증소우청수조（P ﹤0.05），대조조적병사솔균고우미탕조화청수조（P ﹤0.05）。결론비사시일충간편、안전적규정고납혈증적치료방법，사용미탕비사능사환자장공능교쾌회복，차병발증소，치득림상추엄응용。
Objective To compare the clinical results of three methods treating hypernatremia caused by acute brain injury-nasogas-tric rice water or pure water,or intravenous infusion - in relieving severe hypernatremia symptom. Methods 44 patients suffering from hy-pernatremia symptom caused by acute brain injury were divided into three treatment groups:18 patients were treated by nasogastric gavage of rice water,15 patients by nasogastric gavage of pure water,and the other 11 patients by intravenous infusion. The blood sodium levels,recov-ery time for normal sodium levels and bowel sounds,occult blood in stomach contents,mortality rate and complications caused by nasogastric gavage among the three groups were compared. Results The sodium level recovery time in the rice water group(88. 11 ± 7. 14)h was not statistically different with that in the pure water group(93. 07 ± 8. 09)h(P ﹥ 0. 05),but they were shorter than that in the intravenous infu-sion group(179. 36 ± 13. 51)h(P ﹤ 0. 05). The bowel sounds recovery time in the rice water group(32. 17 ± 5. 78)h was shorter than those in the pure water group(90. 00 ± 7. 93)h and the intravenous infusion group(384. 91 ± 35. 71)h(P ﹤ 0. 05). The occult blood of stomach contents in the rice water group was more common than the pure water group,but was less than the intravenous infusion group(P ﹤0. 05). The complications caused by nasogastric gavage in the rice water group were fewer than the pure water group(P ﹤ 0. 05),and the mortality rate in the intravenous infusion group was higher than the other two groups(P ﹤ 0. 05). Conclusion Nasogastric gavage is a sim-ple and safe therapy to treat hypernatremia,and It is worthy of clinical application to use nasogastric rice water for patients with hypernatrem-ia,which would make their bowel function recovery more faster with less complication.
