腹膜透析治疗重型颅脑损伤并发症疗效分析

Curative Effect Analysis of Peritoneal Dialysis in Treating Complications of Severe Craniocerebral Injury

目的探讨腹膜透析治疗重型脑损伤并发症的临床效果。方法应用腹膜透析(PD)治疗重型颅脑损伤30例,以甘露醇脱水,静脉补充电解质治疗同类病员29例为对照组,比较两组的临床效果。结果PD治疗组:1例因脑伤过重死亡,其余治疗情况良好,无严重水电解质紊乱,对有严重脑水肿脑肿胀者,脱水效果良好;3月后GOS评定:痊愈:9例,中残:16例,重残:4例,植物生存:0例,死亡1例。对照组:4例死于急性肾功衰;2例死于弥漫性脑水肿;23例合并有不同程度的水电争质紊乱;3月后GOS评定:痊愈3例,中残14例,重残4例,植物生存2例。结论PD治疗重型颅脑损伤并发脑水肿脑肿胀,纠正严重水电解质紊乱,防止急性肾功衰等,均有良好的临床效果。腹膜透析可作为重型颅脑损伤并发症的有效治疗措施。

Objective To discuss the curative effect of peritoneal dialysis in treating complications of severe craniocerebral injury so as to find out the better treatment. Methods 59 cases with severe craniocerebral injury were divided into 2groups： PD group （ n = 30 ） , receiving PD, and control group （ n = 96 ）, receiving manicol dehydration and electrolyte replenishment by vein. The clinical effects in the 2 groups were compared. Results In PD group,except 1 death of severe craniocerebral injury,others showed out good curative effect,no occurrence of severe water- electrolyte disturbance,and good effect of dehydration in cases with severe cerebral edema or tumefaction ,3 months later, GOS showed out：9 cases with recovery, 16 cases with moderate disability, 4 cases with severe disability, 1 death and no plant man. In control group ,4 cases died of acute renal function failure and 2 of diffuse cerebral edema ,23 cases suffered from water- electrolyte disturbance,3 months later, GOD showed out：3 cases with recovery, 14 cases with moderate disability ,4 cases with severe disability and 2 plant men. Conclusions PD has good effect in treating cerebral edema and tumefaction complicated after severe craniocerebral injury, in retrieving severe water - electrolyte disturbance and in preventing the occurrence of acute renal function failure;it is an effective treatment for complications of severe craiocerebral injury.