等渗剂量7.5%高渗盐水和20%甘露醇降低颅内压的效果比较(1)
[摘要] 目的 比较等渗剂量7.5%高渗盐水和20%甘露醇降低颅内压(ICP)的效果。 方法 回顾性分析陕西中医药大学第二附属医院2015年1月～2018年6月收治的重型颅脑创伤致颅内高压患者的病例资料。其中收集符合纳入标准的病例共30例，根据高渗治疗方法分为7.5%高渗盐水组(15例)和20%甘露醇组(15例)。比较两组患者治疗后ICP降低降幅、起效时间、有效持续时间、ICP最低值所需时间、脑灌注压(CPP)、平均动脉压(MAP)、中心静脉压(CVP)。分析两组患者治疗前及治疗后1、3 h血钠浓度和血漿渗透压。 结果 7.5%高渗盐水组治疗后ICP降低幅度高于20%甘露醇组，起效时间、有效持续时间均长于20%甘露醇组，ICP最低值所需时间短于20%甘露醇组，差异均有统计学意义(均P < 0.05)。7.5%高渗盐水组治疗后CPP及MAP高于20%甘露醇组，差异有统计学意义(P < 0.05);两组治疗后的CVP比较差异无统计学意义(均P > 0.05)。两组治疗前及治疗后1、3 h血浆渗透压、血钠浓度组内比较，差异均有统计学意义(均P < 0.05);两组治疗后1、3 h的血浆渗透压、血钠浓度组间比较，差异均有统计学意义(均P < 0.05)。 结论 7.5%高渗盐水降ICP效果优于20%甘露醇。
[关键词] 高渗盐水;甘露醇;颅内压;重型颅脑创伤
[中图分类号] R742 [文献标识码] A [文章编号] 1673-7210(2019)09(b)-0141-04
Effect comparation of isosmotic dose of 7.5% hypertonic saline and 20% mannitol on intracranial pressure reduction
HUO Shengjie ZHANG Wenqi LIU Jindao WANG Jiangfeng CHEN Chen LI Hao DONG Tao▲
Department of Neurosurgery， the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine， Shaanxi Province， Xianyang 712000， China
[Abstract] Objective To compare the effect of isosmotic dose of 7.5% hypertonic saline and 20% mannitol on intracranial pressure (ICP) reduction. Methods The data of patients with intracranial hypertension caused by severe traumatic brain injury admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2015 to June 2018 were retrospectively analyzed. Among them， 30 cases met the inclusion criteria were collected and divided into 7.5% hypertonic saline group (15 cases) and 20% mannitol group (15 cases) according to hypertonic therapy. The reduction of ICP， onset time， effective duration， minimum ICP time， cerebral perfusion pressure (CPP)， mean arterial pressure (MAP) and central venous pressure (CVP) were compared between two groups. Serum sodium concentration and plasma osmotic pressure were analyzed before treatment and 1 and 3 hours after treatment between two groups. Results After treatment， ICP in 7.5% hypertonic saline group decreased more than that in 20% mannitol group， the onset time and effective duration in 7.5% hypertonic saline group were longer than that in 20% mannitol group， and the minimum ICP time in 7.5% hypertonic saline group was shorter than that in 20% mannitol group， the differences were statistically significant (all P < 0.05). CPP and MAP of 7.5% hypertonic saline group after treatment were higher than those of 20% mannitol group， the differences were statistically significant (P < 0.05). There was no significant difference in CVP between two groups after treatment (P > 0.05). There were statistically significant differences in plasma osmotic pressure and sodium concentration between two groups before treatment and 1 and 3 hours after treatment (all P < 0.05). There were statistically significant differences in plasma osmotic pressure and sodium concentration between two groups 1 and 3 hours after treatment (all P < 0.05). Conclusion ICP reduction effect of 7.5% hypertonic saline is better than that of 20% mannitol., http://www.100md.com(霍生杰 张文岐 金道 王江峰 陈琛李 浩 董 涛)
[关键词] 高渗盐水;甘露醇;颅内压;重型颅脑创伤
[中图分类号] R742 [文献标识码] A [文章编号] 1673-7210(2019)09(b)-0141-04
Effect comparation of isosmotic dose of 7.5% hypertonic saline and 20% mannitol on intracranial pressure reduction
HUO Shengjie ZHANG Wenqi LIU Jindao WANG Jiangfeng CHEN Chen LI Hao DONG Tao▲
Department of Neurosurgery， the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine， Shaanxi Province， Xianyang 712000， China
[Abstract] Objective To compare the effect of isosmotic dose of 7.5% hypertonic saline and 20% mannitol on intracranial pressure (ICP) reduction. Methods The data of patients with intracranial hypertension caused by severe traumatic brain injury admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2015 to June 2018 were retrospectively analyzed. Among them， 30 cases met the inclusion criteria were collected and divided into 7.5% hypertonic saline group (15 cases) and 20% mannitol group (15 cases) according to hypertonic therapy. The reduction of ICP， onset time， effective duration， minimum ICP time， cerebral perfusion pressure (CPP)， mean arterial pressure (MAP) and central venous pressure (CVP) were compared between two groups. Serum sodium concentration and plasma osmotic pressure were analyzed before treatment and 1 and 3 hours after treatment between two groups. Results After treatment， ICP in 7.5% hypertonic saline group decreased more than that in 20% mannitol group， the onset time and effective duration in 7.5% hypertonic saline group were longer than that in 20% mannitol group， and the minimum ICP time in 7.5% hypertonic saline group was shorter than that in 20% mannitol group， the differences were statistically significant (all P < 0.05). CPP and MAP of 7.5% hypertonic saline group after treatment were higher than those of 20% mannitol group， the differences were statistically significant (P < 0.05). There was no significant difference in CVP between two groups after treatment (P > 0.05). There were statistically significant differences in plasma osmotic pressure and sodium concentration between two groups before treatment and 1 and 3 hours after treatment (all P < 0.05). There were statistically significant differences in plasma osmotic pressure and sodium concentration between two groups 1 and 3 hours after treatment (all P < 0.05). Conclusion ICP reduction effect of 7.5% hypertonic saline is better than that of 20% mannitol., http://www.100md.com(霍生杰 张文岐 金道 王江峰 陈琛李 浩 董 涛)