托拉塞米辅助3%高渗盐水治疗重型颅脑损伤致颅内高压患者的效果

Effect of Torasemide Assisted with 3%Hypertonic Saline in the Treatment of Patients with Intracranial Hypertension Caused by Severe Traumatic Brain Injury

目的:研究托拉塞米辅助3%高渗盐水治疗对重型颅脑损伤(sTBI)致颅内高压患者药物起效时间、颅内压(ICP)、氧化应激水平、机体循环的影响。方法:选择2019年1月-2022年4月厦门市中医院收治的75例s TBI致颅内高压患者作为研究对象,按照计算机分组法将患者分为单一组(n=37,3%高渗盐水治疗)与联合组(n=38,托拉塞米辅助3%高渗盐水治疗),比较两组药物起效时间、ICP改善情况、氧化应激水平和机体循环情况。结果:联合组药物起效、ICP降至最低点所用时间均较单一组短,降ICP持续时间较单一组长,ICP最大降幅较单一组大(P<0.05);治疗3 d后,两组超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)均高于治疗前,丙二醛(MDA)均低于治疗前,且联合组SOD、GSH-Px、T-AOC均较单一组高,MDA较单一组低(P<0.05);治疗3 d后,两组平均动脉压(MAP)、脑灌注压(CPP)、中心静脉压(CVP)、血浆渗透压均高于治疗前,且联合组均较单一组高(P<0.05)。结论:托拉塞米辅助3%高渗盐水用于s TBI致颅内高压患者,可缩短药物起效时间,降低颅内高压水平,减轻氧化应激损伤,从而改善机体循环。

Objective:To study the effects of Torasemide assisted with 3% Hypertonic Saline on drug onset time,intracranial pressure(ICP),oxidative stress level and body circulation in patients with intracranial hypertension caused by severe traumatic brain injury(sTBI).Method:A total of 75 patients with intracranial hypertension caused by sTBI who admitted to Xiamen Hospital of Traditional Chinese Medicine from January 2019 to April 2022 were selected as the study objects,and they were divided into the single group(n=37,3% Hypertonic Saline)and the combined group(n=38,Torasemide combined with 3% Hypertonic Saline)according to the computer grouping method.The drug onset time,ICP improvement,oxidative stress level and body circulation of two groups were compared.Result:The time of drug onset and ICP lowering to the lowest point in the combined group were shorter than those in the single group,the duration of lowering ICP was longer than that in the single group,and the maximum decrease of ICP was greater than that in the single group(P<0.05);after 3 d of treatment,the levels of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),total antioxidant capacity(T-AOC)in two groups were higher than those before treatment,while the levels of malondialdehyde(MDA)in two groups were lower than those before treatment,and the levels of SOD,GSH-Px and T-AOC in the combined group were higher than those in the single group,the level of MDA in the combined group was lower than that in the single group(P<0.05);after 3 d of treatment,the mean arterial pressure(MAP),cerebral perfusion pressure(CPP),central venous pressure(CVP)and plasma osmotic pressure in two groups were higher than those before treatment,and the combined group were higher than those in the single group(P<0.05).Conclusion:Torasemide assisted with 3% Hypertonic Saline for patients with intracranial hypertension caused by sTBI can shorten the drug onset time,reduce the level of intracranial hypertension,reduce oxidative stress injury,and improve the body circulation.