等容血液稀释联合控制性降压在颅脑外伤手术治疗中的疗效分析

Therapeutic Effect of Isovolemic Hemodilution Combined with Controlled Hypotension in Surgical Treatment of Craniocerebral Trauma

目的分析等容血液稀释联合控制性降压在颅脑外伤手术治疗中的疗效。方法在2014年1月-2019年1月间入院接受治疗的颅脑外伤患者中选择150例参与此次研究分析,依据患者的入院顺序实施分组,各75例。所有患者均接受开颅血肿完全清除、去骨瓣减压术进行治疗,对照组同时实施控制性降压术为患者进行治疗。观察组则同时实施等容血液稀释联合控制性降压为患者进行治疗。对比治疗效果。结果两组患者全麻插管等溶血液稀释前(T0)时的各项指标对比结果则均提示差异无统计学意义(P>0.05)。其余时刻两组患者平均动脉压、中心静脉压、心率等指标检验结果的对比则显示观察组更优,T1时刻MAP为(92.8±3.4)mmHg、T2时刻为(66.3±3.8)mmHg、T3时刻为(67.1±2.5)mmHg、T4时刻为(85.2±7.2)mmHg。T1时刻CVP为(8.4±1.1)cmH2O、T2时刻为(8.1±0.7)cmH2O、T3时刻为(8.1±0.9)cmH2O、T4时刻为(8.1±0.6)cmH2O。T1时刻HR为(79.9±3.8)次/min、T2为(83.1±2.9)次/min、T3为(82.3±4.2)次/min、T4为(83.1±1.7)次/min(P<0.05)。脑组织氧代谢指标的对比差异无统计学意义(P>0.05)。结论等容血液稀释联合控制性降压在颅脑外伤手术治疗中的效果较为显著,可有效提高术中患者血流动力学稳定,避免增加脑组织氧代谢量,更利于手术治疗的顺利开展,应用价值较高。

Objective To analyze the efficacy of isovolumic hemodilution combined with controlled hypotension in the treatment of craniocerebral trauma.Methods A total of 150 patients who underwent treatment for craniocerebral trauma between January 2014 and January 2019 were enrolled in the study.Groups were divided into 75 patients each accord-ing to the patient's admission sequence.All patients underwent complete removal of craniotomy hematoma and decom-pressive craniectomy.The control group also underwent controlled hypotension for treatment.The observation group was simultaneously treated with isovolumic hemodilution combined with controlled hypotension for treatment.Compare treatment effects.Results The results of the comparison of the indexes before the hemolysis of the two groups of pa tients with general anesthesia intubation(T0)showed no statistically significant difference(P>0.05).At the remaining time,the comparison of the mean arterial pressure,central venous pressure,heart rate and other indicators between the two groups showed that the observation group was better.The MAP at time T1 was(92.8±3.4)mmHg,and the time at T2 was(66.3±3.8)mmHg,T3 was(67.1±2.5)mmHg and T4 was(85.2±7.2)mmHg.At time T1,CVP was(8.4±1.1)cmH2O,T2 was(8.1±0.7)cmH2O,T3 was(8.1±0.9)cmH2O,and T4 was(8.1±0.6)cmH2O.HR at time T1 was(79.9±3.8)times/min,T2 was(83.1±2.9)times/min,T3 was(82.3±4.2)times/min,and T4 was(83.1±1.7)times/min(P<0.05).There was no statistically significant difference in the index of brain tissue oxygen metabolism(P>0.05).Conclusion Isovolu-mic hemodilution combined with controlled hypotension has a significant effect in the treatment of craniocerebral trau-ma,which can effectively improve the hemodynamic stability of the patients during operation,avoid increasing the oxy-gen metabolism of brain tissue,and facilitate the smooth development of surgical treatment.The application value is higher.