脑梗死合并高渗综合征41例救治分析

THE TREATMENT OF 41 CASES OF CEREBRAL INFARCTION WITH HYPERTONIC SYNDROME

目的 探讨脑梗死合并高渗综合征时BNa+、BK+、BCl- 、BGs、Bun、血浆有效渗透压的变化 ,并观察管饲法对脑梗死合并高渗综合征时BNa+、BK+、BCl- 、BGs、有效渗透压的影响。方法 将观察对象分为高渗综合征组 (高渗组 )与正常对照组 ;高渗组治疗分管饲组与对照组。结果 高渗组各项观察指标 (除BK +外 )均明显高于对照组 (P <0 .0 1,P <0 .0 5 ) ;管饲组 2 6例中 2 1例 ,对照组 15例中 8血浆有效渗透压降至 32 0mmol/L以下 (P <0 .0 5 )。管饲组治愈 2 1例 ,死亡 3例 ;对照组治愈 7例 ,死亡 8例 (P <0 .0 1)。结论 高渗综合征主要为BNa+升高 ;降低有效渗透压是救治的关键 ;管饲温开水抢救脑梗死合并高渗综合征可显著降低死亡率。

Objective To explore the changes of BNa +,BK +,BCI ,BGs,Bun and plasma effective osmotic pressure in patients of cerebral infarction and the effects of intubation feeding on them.Methods The subjects were divided into the group of hypertonic syndrome and the contrast group.The group of hypertonic syndrome was further divided into the group of intubation feeding and the contrast group.Results The observation indexes (except BK +) were all higher than those in the cntrast group(P<0.01,P<0.05).The plasma effective osmotic pressure decreased to 320mmol/L in 21 cases in the group of intubation feedng and 8 cases in the contrast group(P<0.05).3 died in the group of intubation feeding and 8 died and 7 were cured in the contrast group(P<0.01).Conclusion Increase in BNa + is the main character of hypertonic syndrome.To reduce the osmotic pressure is the key to treating it.Intubation feeding of warm uater can effectively reduce the death rate in patients with cerebral infarction with hypertonic syndrome.