高渗盐复合液治疗重型颅脑外伤颅内高压并失血性休克的临床效果

Clinical effect of hypertonic sodium chloride hydroxyethyl in the treatment of severe craniocerebral trauma with intracranial hypertension and hemorrhagic shock

目的探讨高渗盐复合液(HSH)治疗重型颅脑外伤颅内高压并失血性休克的临床效果。方法选取我院2018年5月至2019年4月收治的52例重型颅脑外伤颅内高压并失血性休克患者作为研究对象,通过计算机随机分组法将患者分为甘露醇组(26例,甘露醇治疗)和HSH组(26例,HSH治疗)。比较两组的治疗效果。结果治疗后,两组的颅内压、脑动静脉氧含量差均降低,颈静脉球血氧饱和度均升高,且HSH组明显优于甘露醇组(P<0.05)。治疗后,两组的CVP与MAP均升高,且HSH组明显高于甘露醇组(P<0.05)。随访6个月,HSH组患者的恢复良好率明显高于甘露醇组(P<0.05);两组的重残和植物生存状态率、死亡率比较,差异无统计学意义(P>0.05)。结论HSH治疗重型颅脑外伤颅内高压并失血性休克的临床效果显著,可有效控制患者颅内压,纠正休克症状,改善患者的预后情况。

Objective To explore the clinical effect of hypertonic sodium chloride hydroxyethyl(HSH)in the treatment of severe craniocerebral trauma with intracranial hypertension and hemorrhagic shock.Methods A total of 52 severe craniocerebral trauma patients with intracranial hypertension and hemorrhagic shock admitted in our hospital from May 2018 to April 2019 were selected as the study objects.The patients were divided into mannitol group(26 cases,mannitol treatment)and HSH group(26 cases,HSH treatment)by computer random grouping method.The therapeutic effects of the two groups were compared.Results After treatment,the intracranial pressure and cerebral arteriovenous oxygen content difference in the two groups decreased,the jugular blood oxygen saturation increased,and those in the HSH group were significantly better than the mannitol group(P<0.05).After treatment,CVP and MAP in both groups increased,and those in the HSH group were significantly higher than the mannitol group(P<0.05).After 6 months follow-up,the recovery good rate in the HSH group was significantly higher than that in the mannitol group(P<0.05);there were no significant differences in severe disability and plant survival rate,mortality rate between the two groups(P>0.05).Conclusion HSH in the treatment of severe craniocerebral trauma with intracranial hypertension and hemorrhagic shock has a significant clinical effect,it can effectively control patients'intracranial pressure,correct shock symptoms,and improve prognosis.