高渗盐复合液治疗急性颅脑损伤的实验研究

Research of treatment of acute brain injury with hypertonic sodium chloride hydroxyethylstarch-40 injection

目的:探讨高渗氯化钠羟乙基淀粉40溶液(以下简称高渗盐复合液)对外伤性颅内高压和脑水肿的治疗作用。方法:制作猫中型液压颅脑损伤模型,伤后3 h行高渗盐复合液、甘露醇和乳酸林格氏液治疗。比较伤前、治疗时、治疗后 30、60、90和120 min的颅内压及血钠变化。动物处死后测量脑组织含水量。结果:高渗盐复合液组和甘露醇组用药后动物颅内压均立即下降,维持时间上无明显差异(P>0．05);而乳酸林格氏液组颅内压无下降。3组动物受伤侧脑组织含水量无明显差别(P>0．05);高渗盐复合液组和甘露醇组的未损伤侧脑组织含水量差别不大,但均明显低于乳酸林格氏液组(P<0．05);高渗盐复合液组于用药后30、60、90 min时血钠明显升高。结论:高渗盐复合液具有与甘露醇同样的作用,可有效地降低颅内压和对未损伤侧脑组织脱水,从而为临床救治急性颅脑损伤提供一种有效的复苏液体。

Objective： To investigate the therapeutic effects of hypertonic sodium chloride hydroxyethylstarch - 40 injection（HSH） on intracranial hypertension and brain edema, Methods： Middle brain injury model was performed in cats subjected to fluid - percussion traumatic brain injury. 3 h later, each animal received rapid intravenous administration of either HSH, of 20% mannitol or of RL. Data（ICP and serum Na ＋） were collected at baseline and at 0, 30, 60, 90 and 120 min after the injection. Aider the animals were sacrificed, the water content of the injured and uninjured hemisphere was measured. Results： After the injection, ICP lowered quickly in goup HSH and group mannitol, but did not lowered in group RL group（p 〉 0.05）. There was not difference of water content in brain tissue of injured hemisphere among three groups（p 〉 0.05）. The water content in brain tissue of un - injured hemisphere was similar between group HSH and group mannnitol, but was significantly lower than that in goup RL（p 〈 0.05）. After the injection of HSH 30, 60 and 90 min, the level of serum Na ＋ increased. Conclusion： It is demonstrated that HSH is as effective as mannitol on traumatic intracranial hypertension and brain edema by means of decreasing ICP and reducing water content in the un - injured bemisphere, and it may be an effective resuscitation fluid used to treat acute brain injury.