脑出血术后颅内高压患者的循证治疗

Evidence-based Treatment for Patients with Intracranial Hypertension after Cerebral Hemorrhage Operation

目的探讨脑出血术后颅内高压患者的循证治疗。方法选取2013年9月—2015年11月该院收治的70例脑出血术后颅内高压患者,随机分成治疗组和对照组,各35例。治疗组患者随机使用高渗盐水或甘露醇降颅压,对照组患者单用甘露醇降颅压,分析脑出血术后颅内高压患者最佳治疗方法。结果采用高渗盐水患者的降压时间为(34.72±7.49)h及降压持续时间为(251.89±69.01)h明显低于采用甘露醇患者的(43.80±8.09)h、(192.03±40.97)h;且治疗组患者血清Na+离子浓度及血浆渗透压明显高于对照组患者,差异有统计学意义(P<0.05)。结论临床上治疗脑出血术后颅内高压患者采用的药物治疗主要以甘露醇和高渗盐水为主,由于缺乏强有力的非药物治疗论证,因此尚不能否定非药物治疗的价值,所以还需要进一步开展研究。

Objective To study the evidence-based treatment for patients with intracranial hypertension after cerebral hemorrhage operation. Methods 70 cases of patients with intracranial hypertension after cerebral hemorrhage operation admitted and treated in our hospital from September 2013 to November 2015 were selected and randomly divided into two groups with 35 cases in each, the treatment group were randomly treated with hypertonic saline or mannitol for intracranial decompression, the control group were treated with single mannitol for intracranial decompression, and the best treatment methods of patients with intracranial hypertension after cerebral hemorrhage operation were analyzed. Results The decompression time and decompression duration in patients with hypertonic saline were obviously lower than those in patients with mannitol [（34.72±7.49） h,（251.89±69.01） h vs（43.80±8.09） h,（192.03±40.97） h], and the serum Na＋ ion concentration and plasma osmotic pressure in the treatment group were obviously higher than those in the control group, and the difference had statistical significance（P〈0.05）. Conclusion The drug in clinical treatment of patients with intracranial hypertension after cerebral hemorrhage operation is mainly mannitol and hpertonic saline, and we cannot deny the value of non-drug treatment due to lack of the powerful non-drug treatment argument, therefore, we need to further carry out the research.