高渗盐水治疗重型颅脑损伤疗效及安全性评价

目的探讨高渗盐水对重型颅脑损伤的治疗效果及安全性评价。方法收集2016年1月至2018年1月本院重型颅脑损伤患者,分成对照组及观察组,比较两组患者伤后1周时的GCS评分,血清神经元特异烯醇化酶(NSE)浓度,甘露醇总用量,脑梗塞发生率,6个月后预后良好率、死亡率,同时分析比较两组患者电解质紊乱,凝血功能,肝肾功能,结果对照组57例,观察组56例,两组患者入院时年龄、性别、格拉斯哥昏迷评分(GCS)、NSE均无统计学差异(P>0.05),观察组1周时GCS评分,甘露醇用量,NSE均优于对照组,差异有统计学意义(P<0.05),伤后1周两组电解质紊乱,凝血功能,肝肾功能方面等方面差异无统计学意义(P>0.05)。结论高渗盐水治疗重型颅脑损伤有一定作用,而且副作用少,安全性高,有可能成为一种较理想的脑保护剂。

Objective To investigate the efficacy and safety of hypertonic saline in the treatment of severe traumatic brain injury.Methods Severe craniocerebral trauma patients in 2016.1~2018.1 were involved in the study and were divided into control group and experimental group(routine management plus hypertonic saline).Glasgow coma scale(GCS),serum neuron specific enolase(NSE)level,total mannitol dosages,cerebral infarction,prognosis,mortality rate,electrolyte disturbance,coagulation,liver and kidney function were analyzed and compared between the two groups.Results A total of 113cases were enrolled,including 57 cases in the control group and 56 cases in the experimental group.There were no significant differences in age,gender,glasgow coma scale(GCS)and NSE level between the two groups at admission(P>0.05).GCS,NSE,total mannitol dosage one week after injury,were significantly improved in experimental group compared to control group(P<0.05).There was no significant difference in electrolyte disturbance,coagulation function,liver and kidney function between the two groups.Conclusion Hypertonic saline has some effects on severe craniocerebral injury with fewer side effects and higher safety.It might be an effective cerebral protective agent.