国际中医中药杂志
國際中醫中藥雜誌
국제중의중약잡지
International Journal of Traditional Chinese Medicine
2015年
9期
785-787
,共3页
张珏%许乐宜%龚立%书国伟%王静予%蔡佩浩%邱锋%孔令军%费智敏
張玨%許樂宜%龔立%書國偉%王靜予%蔡珮浩%邱鋒%孔令軍%費智敏
장각%허악의%공립%서국위%왕정여%채패호%구봉%공령군%비지민
颅脑损伤%脑水肿%手术后并发症%芒硝%外治法
顱腦損傷%腦水腫%手術後併髮癥%芒硝%外治法
로뇌손상%뇌수종%수술후병발증%망초%외치법
Craniocerebral trauma%Brain edema%Postoperative complications%Natrii sulfas%External therapies
目的 评价芒硝外敷治疗颅脑外伤去骨瓣减压术后脑水肿的临床疗效.方法 将符合纳入标准的颅脑外伤去骨瓣减压术后患者60例,按随机数字表法分为2组各30例,2组均在颅内压监测基础上行阶梯化治疗,常规治疗组在伤口处以消毒棉垫覆盖减压窗,芒硝外敷组以一次性芒硝敷料袋覆盖减压窗.观察患者术后1周每日颅内压(intracranial pressure, ICP)均值及脑电双频指数(bispectral index, BIS)均值,记录患者住院时间、费用,评价临床疗效.结果 芒硝外敷组ICP均值在术后第2天[(32±2.2)mmHg比(35±2.2)mmHg,t=2.351]、第 3 天[(31±2.0)mmHg 比(33±2.1)mmHg,t=2.224]、第 5 天[(26± 2.3)mmHg 比(28±1.9)mmHg,t=2.536]均低于常规治疗组(P<0.05);BIS均值在术后第3天[(47±4.3)比(43±4.2),t=2.379]、第5天[(55±5.3)比(52±3.9),t=2.559]均高于常规治疗组(P<0.05).平均住院时间,芒硝外敷组为(16.5±1.2)d、常规治疗组为(17.2±1.1)d,2组比较差异有统计学意义(t=2.355,P=0.022).平均住院费用,芒硝外敷组为(7.37±0.68)万元、常规治疗组为(8.14±1.12)万元,2组比较差异有统计学意义(t=2.056,P=0.042).结论 芒硝外敷可有效缓解颅脑外伤去骨瓣减压术后的脑水肿.
目的 評價芒硝外敷治療顱腦外傷去骨瓣減壓術後腦水腫的臨床療效.方法 將符閤納入標準的顱腦外傷去骨瓣減壓術後患者60例,按隨機數字錶法分為2組各30例,2組均在顱內壓鑑測基礎上行階梯化治療,常規治療組在傷口處以消毒棉墊覆蓋減壓窗,芒硝外敷組以一次性芒硝敷料袋覆蓋減壓窗.觀察患者術後1週每日顱內壓(intracranial pressure, ICP)均值及腦電雙頻指數(bispectral index, BIS)均值,記錄患者住院時間、費用,評價臨床療效.結果 芒硝外敷組ICP均值在術後第2天[(32±2.2)mmHg比(35±2.2)mmHg,t=2.351]、第 3 天[(31±2.0)mmHg 比(33±2.1)mmHg,t=2.224]、第 5 天[(26± 2.3)mmHg 比(28±1.9)mmHg,t=2.536]均低于常規治療組(P<0.05);BIS均值在術後第3天[(47±4.3)比(43±4.2),t=2.379]、第5天[(55±5.3)比(52±3.9),t=2.559]均高于常規治療組(P<0.05).平均住院時間,芒硝外敷組為(16.5±1.2)d、常規治療組為(17.2±1.1)d,2組比較差異有統計學意義(t=2.355,P=0.022).平均住院費用,芒硝外敷組為(7.37±0.68)萬元、常規治療組為(8.14±1.12)萬元,2組比較差異有統計學意義(t=2.056,P=0.042).結論 芒硝外敷可有效緩解顱腦外傷去骨瓣減壓術後的腦水腫.
목적 평개망초외부치료로뇌외상거골판감압술후뇌수종적림상료효.방법 장부합납입표준적로뇌외상거골판감압술후환자60례,안수궤수자표법분위2조각30례,2조균재로내압감측기출상행계제화치료,상규치료조재상구처이소독면점복개감압창,망초외부조이일차성망초부료대복개감압창.관찰환자술후1주매일로내압(intracranial pressure, ICP)균치급뇌전쌍빈지수(bispectral index, BIS)균치,기록환자주원시간、비용,평개림상료효.결과 망초외부조ICP균치재술후제2천[(32±2.2)mmHg비(35±2.2)mmHg,t=2.351]、제 3 천[(31±2.0)mmHg 비(33±2.1)mmHg,t=2.224]、제 5 천[(26± 2.3)mmHg 비(28±1.9)mmHg,t=2.536]균저우상규치료조(P<0.05);BIS균치재술후제3천[(47±4.3)비(43±4.2),t=2.379]、제5천[(55±5.3)비(52±3.9),t=2.559]균고우상규치료조(P<0.05).평균주원시간,망초외부조위(16.5±1.2)d、상규치료조위(17.2±1.1)d,2조비교차이유통계학의의(t=2.355,P=0.022).평균주원비용,망초외부조위(7.37±0.68)만원、상규치료조위(8.14±1.12)만원,2조비교차이유통계학의의(t=2.056,P=0.042).결론 망초외부가유효완해로뇌외상거골판감압술후적뇌수종.
Objective To study the effects of external application of mirabilite in the treatment of brain injury patients with brain edema postoperative of decompressive craniectomy.Methods 60 brain injury patients from the department of neurosurgery in shuguang hospital,who were underwent decompressive craniectomy, were randomly divided into a control group and an observation group, with 30 patients in each.. The observation group was treated according to the results of intracranial pressure (ICP) monitoring. The control group was underwent additional external application of mirabilite. Comparisons were conducted on daily ICP, bispectral index(BIS) and Glasgow coma scale (GCS) in postoperative one week. The hospitalization days and expense were also be analysed. All patients were treated for 3 months and the Glasgow outcome scale (GOS) was recorded. Result The ICP of control group was lower than the observational group in postoperative day 2,3 and 5 (32±2.2 mmHgvs. 35± 2.2 mmHg,t=2.351; 31±2.0 mmHgvs. 33±2.1 mmHg,t=2.224; 26±2.3 mmHgvs. 28±1.9 mmHg, t=2.536), the BIS is higher in day 3 and 5(47±4.3 vs.43±4.2 t=2.379; 55±5.3 vs.52±3.9, t=2.559). There was significant difference in hospitalization days between the two groups (16.5 ± 1.2 dvs. 17.2 ± 1.1 d, t=2.355,P=0.022). There was significant difference between the two groups(P<0.05). There was also significant difference in hospitalization expense with 7.37 ± 0.68(million yuan) in the control group and 8.14 ±1.12 in the observational group(t=2.056,P=0.042).Conclusion The external application of mirabilite was effective in the treatment of brain injury patient with brain edema postoperative of decompressive craniectomy.
