高渗盐水与甘露醇联合对重型颅脑损伤后颅内压增高患者血肌酐水平及格拉斯哥昏迷评分的影响

Effect of Hypertonic Saline and Mannitol on Scr Level and GCS Score in Patients with Increased Intracranial Pres-sure after Severe Head Injury

目的:针对重型颅脑损伤后颅内压增高患者采用高渗盐水与甘露醇治疗,旨在对其血肌酐(Scr)水平及格拉斯哥昏迷(GCS)评分的影响进行深入探讨。方法:选取河南科技大学第二附属医院2017年5月至2018年4月收治的重型颅脑损伤后颅内压增高患者85例纳入研究并随机编号1~85号,将奇数号患者纳入A组(n=43),偶数号患者纳入B组(n=42)。A组采用甘露醇治疗措施,B组在A组基础上联合高渗盐水治疗措施,比较两组临床疗效、格拉斯哥昏迷指数(GCS)评分及血肌酐(Scr)及尿素氮(BUN)指标。结果:B组临床总有效率(95.24%)高于A组(79.07%),差异有统计学意义(χ^(2)=4.930,P=0.026);两组疗后GCS评分均上升,且B组低于A组,差异有统计学意义(t=2.017,P=0.047);疗后两组Scr、BUN指标均下降,B组Scr及BUN低于A组,差异无统计学意义(t=5.528,4.869,P均<0.001)。结论:针对重型颅脑损伤后颅内增压患者采用高渗盐水联合甘露醇可有效降低患者颅内压,有助于快速恢复意识,同时改善血清Scr,减少肾损伤,疗效显著。

Objective:To treat patients with increased intracranial pressure after severe craniocerebral injury by hypertonic saline and mannitol,aiming to make an in-depth discussion on the effects of Scr level and GCS score.Methods:85 patients with increased intracranial pressure after severe head injury treated in the hospital from May 2017 to April 2018 were selected and included in the study and randomly numbered 1~85,and odd-numbered patients were included in group A(n=43),even numbered patients were included in group B(n=42).Group A was treated with mannitol,and group B was combined with hypertonic saline on the basis of group A.The clinical efficacy,Glasgow coma index(GCS) score,blood creatinine(Scr) and urea nitrogen(BUN) indexes were compared between the two groups.Results:The total clinical effective rate of group B(95.24%) was higher than that of group A(79.07%),the difference was statistically significant(χ^(2)=4.930,P=0.026);the GCS score of both groups increased after treatment,and group B was lower than group A,the difference was statistically significant(t=2.017,P=0.047).After treatment,the Scr and BUN indicators of both groups decreased,and the Scr and BUN of group B were lower than that of group A,the difference was not statistically significant(t=5.528,4.869,P<0.001).Conclusion:The use of hypertonic saline combined with mannitol for patients with intracranial pressurization after severe craniocerebral injury can effectively reduce the intracranial pressure of the patients,help to quickly restore consciousness,and improve serum Scr,reduce kidney injury,and has a significant effect.