高渗盐水治疗重型颅脑创伤合并休克患者的临床应用价值

目的:探讨高渗盐水治疗方法治疗重型颅脑创伤合并休克患者的临床应用价值。方法:回顾性分析本院收治的64例重型颅脑损伤合并休克患者的临床资料,根据治疗方法不同分为高渗盐组和甘露醇组,分别静脉滴注7.5%的高渗盐水和20%甘露醇进行治疗,比较两组患者治疗前后的MAP、CPP以及APACHEⅡ评分和GCS评分。结果:治疗前,两组患者的MAP、CPP、APACHEⅡ评分、GCS评分差异均无统计学意义(P0.05)。治疗后,高渗盐组患者的MAP、CPP均显著高于甘露醇组,两组比较差异均有统计学意义(P0.05)。治疗后1 d和5 d,高渗盐组患者的APACHEⅡ评分均显著低于甘露醇组,两组比较差异有统计学意义(P0.05),GCS评分均高于甘露醇组且第5 d两组比较差异有统计学意义(P0.05)。结论:高渗盐水治疗方法治疗重型颅脑创伤合并休克,明显升高患者的MAP、CPP,无反跳现象,显著降低APACHEⅡ评分、显著提高GCS评分,临床效果显著。

The Value of the Clinical Application of Hypertonic Saline in the Treatment of Patients with Severe Traumatic Brain Injury Combined with Shock

Objective：To investigate the value of the clinical application of hypertonic saline in the treatment of patients with severe traumatic brain injury combined with shock.Method：The clinical data of 64 cases admitted to the hospital with severe head injury with shock were retrospectively analyzed. According to the different treatment methods,they were divided into the hypertonic saline group and the mannitol group,and they were taken with 7.5%intravenous hypertonic saline or 20%mannitol treatment. The MAP,CPP,APACHEⅡscore and GCS score for the two groups before and after treatment were compared. Result：Before treatment,the MAP,CPP,APACHEⅡ,GCS score of the two groups had no significant difference（P〉0.05）. After treatment,the MAP,CPP score in the hypertonic saline group were significantly higher than the mannitol group（P〈0.05）. 1 day and 5 days after treatment,the hypertonic saline group of patients with APACHEⅡscore was significantly lower than the mannitol group（P〈0.05）,GCS score was higher than mannitol group（P〈0.05）.Conclusion：Hypertonic saline in the treatment of severe craniocerebral trauma with shock significantly improve patients with MAP,CPP,and there is no rebound phenomenon,significantly decrease APACHEⅡscore and significantly increase GCS score,and the clinical effect if significant.