微量泵泵入利尿合剂在治疗重度脑创伤中的作用分析

Diuretic mixture infused with micro-pump in the treatment of severe head injury

目的探讨使用微量泵持续泵入利尿合剂在治疗重度脑创伤治疗中的作用及其对脑、心、肺、肾的影响。方法重度脑创伤病人197例,治疗组伤后6-24 h开始用微量泵持续泵入利尿合剂,监测颅内压(ICP),心、肺、肾等合并症的发生率及两周内死亡率、GCS评分。结果治疗组病人平稳度过脑水肿高危期,出现心、肺、肾等器官的损害明显低于对照组。结论在重度脑创伤中应用利尿合剂除了均匀的利尿脱水外．维持血流动力学相对稳定,可以减少脱水剂的用量以及脱水剂对肾功能的损害,同时对改善心、肺功能也具有重要意义。

Objective To study the influence of diuretic mixture infused with micro-pump on brain, heart, lung and kidney in the treatment of severe head injury. Methods 197 patients with severe head injury hospitalized in our hospital from Feb. 1998 to Jan. 2004 were randomized into two groups： 99 patients in the experimental group were treated with diuretic mixture by continuous infusion of with micro-pump 6-24 hours after they were been injured and another 98 as controls treated conventionally. The incidence rate of complications in heart, lung and kidney and two-week death rate were monitored and GCS was used to grade the patients. Results All the patients in the experimental group lived smoothly though the high risk stage of brain edema. The occurrence rate of damage in heart, lung and kidney was statistically lower than that in the control group. Conclusion Besides steady diureses and dehydration, diuretic mixture by infusion with micro-pump is effective in keeping hemodynamics steady, reducing the administration of dehydrating agents and alleviating the damage of the agents to kidney function. So it can improve the functions of heart and lung.