[精品][经典]高渗氯化钠羟乙基淀粉40注射液对创伤性脑损伤疗效的观察.doc

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1、［经典］高渗氯化钠瓮乙基淀粉40注射液对创伤性脑损伤疗效的观察高渗氯化钠轻乙基淀粉40注射液对创伤性脑损伤疗效的观察［摘耍］0的:观察高渗氯化钠轻乙基淀粉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(TCP)、血浆渗透压、平均动脉压(MAP)、脑灌注压(CPP)、血清N&+浓度、肾功能等指标。结果：与给药前相比较，两组给药后TCP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

2、于试验组，于60min时对照组ICP即明显高于试验组，两者差异有统计学意义(P<0.05)o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N&+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)o两组各时间点血浆渗透压均明显升高，高于给药前(P<0.05)o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TCP效果优于20%甘露醇，能较长时

3、间维持TCP于较低水平,并可同时提高CPP,且肾功能损害等毒副作用轻。［关键词］疑乙基淀粉/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［屮图分类号］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-gangl,GONGYongl,ZHOUMan-hong2(1.DepartmentofNeurosurgery,BeijingYouanmenHospitai,Beijing100054,China;2.MedicalCollegeofNankaiUniversity,Tianjin300071,China)[Abstract]Objective:Toobservetheeffectsandsafetyofhypertonicsodiumchloridehydroxyethylstarch40injectio

5、n(HSH40)onbrainedemainducedbytraumaticbraininjury.Methods：64patientsdiagnosedastraumaticbraininjury(TBI)wererandomlydividedintotwogroups,bothweretakencombinedtreatment・Thetreatmentgroup(n=32)wastreatedwithHSH40pluscombinedtherapy;thecontrolgroup(n=32)wastreatedwith20%mannito

6、1.Intracranialpressure(ICP),plasmaosmoticpressure,meanarterialpressure(MAP),cerebralperfusionpressure(CPP),serumNa+concentrations,renalfunctionweremonitored・Results：ICPdecreasedsignificantlyinthetwogroupsaftertheadministration,buttheaugmentofICPdecreasedinthecontrolgroupwasl

7、owerthanthetreatmentgroup(P<0.05)・UpswingofICPdecreasedinthecontrolgroupwasalsofasteranditsquantitativevaluewassignificantlyhigherthanthetreatmentgroupat60min(P<0.05).CPPincreasedsignificantlyinthetreatmentgroupsaftertheadministrationincomparisonwithprioradministrationandthe

8、controlgroupatalltimes(P<0.05).CCPdidnotsignificantlyincreaseinthecontrolgr