10％高渗盐水治疗急性脑血管病的临床研究

Clinical analysis of using 10% hypertonic saline in treatment of acute cerebrovascular diseases

目的观察10％高渗盐水治疗急性脑血管病的疗效及副作用。方法将30例清醒急性脑血管病患者分为两组：高渗盐水治疗组（HS组）和甘露醇治疗组（M组）。HS组静注10％盐水40ml／12h连续5d；M组静滴20％甘露醇250ml 30min内滴完，1次／12h连续5d。用药前及用药后1、3、7d测患者血清电解质、渗透压、肾功能。治疗前及治疗14d后对患者进行神经功能缺损评分。结果高渗盐水组患者治疗后第1、3、7天血清Na^＋、Cr及渗透压虽有所升高但均无统计学意义，且患者无肾功能损害；甘露醇组患者治疗后第1、3、7天血清Na^＋、Cr及渗透压无明显升高，但出现肾功能损害。治疗14d后高渗盐水组及甘露醇组患者神经功能缺损状况均有明显改善。结论10％高渗盐水可有效治疗急性脑血管病引起的颅内高压，与甘露醇相比效力相当且对肾功能无损害。10％高渗盐水作为降低急性脑血管病性颅内高压的药物是安全、有效的。

Objective To observe the therapeutic and side effects of 10% hypertonic saline solution in treatment of patients with acute eerebrovascular diseases. Method Thirty patients with acute eerebrovaseular diseases were divided into 2 groups randomly, and 10% hypertonic saline （ HS group） or 20% mannitol （ M group） was administered. Patients in HS group were treated with 10% hypertonic saline solution 40 ml, and patients in M group were treated with 20% mannitol 250ml. Each of the two solutions was used every 12 hours a day for 5 days. Plasma electrolytes, osmotic pressure and renal function were measured before or on the first, third, and seventh day of administration. In addition, all patients were scored based on deficit of their clinical neurological function. Results Plasma sodium, chloride, and osmotic pressure had no difference between two groups. Renal function didn＇t damage in HS group, however, renal function was injuried in M group. Neurological function was remarkably improved in both groups. Conclusions Ten percent hypertonic saline solution could effectively reduce intraeranial hypertension in patients with acute eerebrovaseular diseases, and it was safety and effective.