七叶皂甙钠联合甘露醇治疗创伤性脑水肿的脱水效果及对患者颅内压、炎症介质水平的影响

Effects of sodium aescinate combined with mannitol on dehydration and the levels of intracranial pressure and inflammatory mediatorsin patients with traumatic brain edema

目的观察七叶皂甙钠联合甘露醇治疗创伤性脑水肿患者脱水效果及对颅内压、炎症介质水平的影响。方法选取2015年1月～2017年1月陕西省榆林市第二医院收治的80例创伤性脑水肿患者，随机分为对照组和观察组，每组40例。对照组给予甘露醇脱水治疗，观察组给予七叶皂甙钠联合甘露醇治疗；比较2组治疗效果。结果治疗后，观察组较对照组血清肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-1β（IL-1β）及全血高切黏度、全血低切黏度均明显降低，脑水肿体积、中线移位明显减小，颅内压明显降低，GCS评分明显升高、NIHSS评分明显降低，差异均有统计学意义（P＜0.05）。结论七叶皂甙钠辅治创伤性脑水肿，有效减轻炎症反应，改善微循环，促进水肿消除，降低颅内压，减轻神经缺损症状。

Objective To observe the effects of sodium aescinatecombined with mannitol on dehydration and the levels of intracranial pressure and inflammatory mediators in patients with traumatic brain edema.Methods80cases of patients with traumatic brain edema from January2015to January2017were randomly divided into the control group and the observation group with40cases in each group.The control group was treated with mannitol dehydration and the observation group was treated with sodium aescinate combined with mannitol.The treatment effects of the two groups were compared.Results After treatment,the levels of TNF-α、CRP、IL-1β,whole blood high viscosity and whole blood low viscosity,the volume of brain edema,the midline shift and the intracranial pressure in the observation group were significantly decreased compared with those in the control group,and the GCS score was significantly increased while the NIHSS score was significantly decreased in the observation group compared with those in the control group(P<0.05).Conclusions Sodium aescinate can effectively reduce the inflammatory response,improve the microcirculation and edema elimination,and reduce intracranial pressure and the nerve defects symptoms in the adjuvant treatment of traumatic brain edema.