血浆渗透压监测在中、重型颅脑外伤治疗中的价值

Role of plasma osmolality measurement in moderate or severe craniocerebral trauma

目的探讨血浆渗透压监测在中、重型颅脑外伤治疗中的价值。方法对136例中、重型颅脑外伤患者进行入院时GCS伤情评分、血浆渗透压及血电解质、血糖、肾功能等测定,并行GOS预后评定。结果脑伤越重,血浆渗透压越高(P<0.05);入院时血浆渗透压水平与血钠、血糖、血尿素氮相关;住院期间死亡者及随访植物生存者入院血浆渗透压水平(335.66±12.13)mmol/L均高于存活者(315.2±9.03)mmol/L,(P<0.05)。结论血浆渗透压是评价急性中、重型颅脑外伤伤情、预后并指导治疗的可靠指标之一。

Objective To evaluate the role of plasma osmolality measurement in 136 patients with moderate or severe craniocerebral trauma. Methods The plasma osmolality、blood electrolytes、blood sugar,and renal function of 136 cases were measured at admission. The patients were marked with GCS at admission and graded with GOS after they were discharged. Results The level of plasma osmolality was found to be higher when the brain injury was more severe. The level of plasma osmolality was closely related with blood Na、blood sugar and blood urea nitrogen. The level of plasma osmolality in the cases who died or were at vegetative state was significantly higher than that of the survi als(P<0.05). Conclusion Plasma osmolality measurement plays an important role in judging condition of craniocerebral trauma,predicting outcome and directing treatment of craniocerebral trauma.