高渗氯化钠羟乙基淀粉40注射液对创伤性脑损伤疗效观察

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1、高渗氯化钠羟乙基淀粉40注射液对创伤性脑损伤疗效观察[摘要]目的:观察高渗氯化钠羟乙基淀粉40(HSH40)注射液治疗创伤性脑损伤脑水肿的疗效及安全性。方法:将64例颅脑损伤患者随机分为试验组和对照组（各32例）,在综合治疗基础上分别予HSH40和20%甘露醇治疗。检测两组颅内压(ICP)、血浆渗透压、平均动脉压(MAP)、脑灌注压(CPP)、血清Na+浓度、肾功能等指标。结果：与给药前相比较,两组给药后ICP均明显下降(P＜0.05),但对照组总的下降水平低于试验组,回升速度也大于试验组,于60min时对照组ICP即明显高

2、于试验组,两者差异有统计学意义(P＜0.05)。给药后试验组各时间点CPP均高于给药前,并高于对照组同时间点(P＜0.05)；而对照组与给药前相比无显著性升高,差异无统计学意义(P＞0.05)。给药后试验组各时间点血清Na+浓度均高于给药前,并高于对照组同时间点(P＜0.05)；而对照组较给药前无显著性升高,差异无统计学意义(P＞0.05)。两组各时间点血浆渗透压均明显升高,高于给药前(P＜0.05)。结论：HSH40治疗创伤性脑损伤后脑水肿效果确切且较为安全,降低ICP效果优于20%甘露醇,能较长时间维持ICP于较低水平,

3、并可同时提高CPP,且肾功能损害等毒副作用轻。12［关键词］羟乙基淀粉/治疗应用；盐水,高渗/治疗应用；创伤性脑损伤；脑水肿；颅内压；甘露醇［中图分类号］R651.15;R977.7［文献标识码］A［文章编号］1671-7256(2011)02-0149-04doi：10.3969/j.issn.1671-7256.2011．02.008Clinicalobservationofhypertonicsodiumchloridehydroxyethylstarch40injectionintreatingtraumaticbr

4、aininjuryYANGZhi-gang1，GONGYong1，ZHOUMan-hong2(1.DepartmentofNeurosurgery,BeijingYouanmenHospital,Beijing100054,China;2.MedicalCollegeofNankaiUniversity,Tianjin300071,China)［Abstract］Objective:Toobservetheeffectsandsafetyofhypertonicsodiumchloridehydroxyethylstarch

5、40injection(HSH40)onbrainedemainducedbytraumaticbraininjury.Methods：64patientsdiagnosedastraumaticbraininjury(TBI)wererandomlydividedintotwogroups,bothweretakencombinedtreatment.Thetreatmentgroup(n=32)wastreatedwithHSH40pluscombinedtherapy;the12controlgroup(n=32)wa

6、streatedwith20%mannitol.Intracranialpressure(ICP),plasmaosmoticpressure,meanarterialpressure(MAP),cerebralperfusionpressure(CPP),serumNa+concentrations,renalfunctionweremonitored.Results：ICPdecreasedsignificantlyinthetwogroupsaftertheadministration,buttheaugmentofI

7、CPdecreasedinthecontrolgroupwaslowerthanthetreatmentgroup(P＜0.05).UpswingofICPdecreasedinthecontrolgroupwasalsofasteranditsquantitativevaluewassignificantlyhigherthanthetreatmentgroupat60min(P＜0.05).CPPincreasedsignificantlyinthetreatmentgroupsaftertheadministratio

8、nincomparisonwithprioradministrationandthecontrolgroupatalltimes(P＜0.05).CCPdidnotsignificantlyincreaseinthecontrolgroup(P＞0.05).SerumNa+concentr