高血压脑出血术后颅内高压应用高渗盐水与甘露醇治疗的效果研究

李伟++陈水钰++顾翔++洪国新

[摘要] 目的 探討高渗盐水与甘露醇治疗高血压脑出血术后颅内高压的效果。方法 随机选取该院2014年7月—2016年7月接诊的高血压脑出血术后颅内高压患者50例作为研究对象，入选对象临床资料完整，自愿配合该研究，随机分组，各自25例。对照组患者采取甘露醇治疗，研究组患者采取高渗盐水治疗，对两组患者降颅压效果、降压起效时间、降压持续时间、血清钠水平，以及治疗前后神经功能缺损评分进行观察记录，并对比分析。结果 研究组总有效率为84%，对照组总有效率为80%；研究组降压起效时间为（24.32±4.73）min，对照组降压起效时间为（23.99±4.26）min；研究组降压持续时间为（4.56±0.53）min，对照组降压持续时间为（3.54±0.45）min；研究组血清钠水平为（3.78±0.86）mmol/L，对照组血清钠水平为（3.35±0.83）mmol/L；研究组治疗前后神经功能缺损评分分别为（25.86±6.34）分和（20.54±4.12）分，对照组治疗前后神经功能缺损评分分别为（25.77±6.18）分和（20.78±4.26）分。两组患者降颅压总有效率、降压起效时间、血清钠水平比较差异无统计学意义（P>0.05），但研究组降压持续时间明显长于对照组（P<0.05）；两组患者神经功能缺损评分治疗前差异无统计学意义（P>0.05），治疗后均有改善（P<0.05），但组间比较差异无统计学意义（P>0.05）。结论 高渗盐水与甘露醇治疗高血压脑出血术后颅内高压可取得相同的效果，但高渗盐水降颅压持续时间更长，值得借鉴。

[关键词] 高血压脑出血；术后颅内高压；高渗盐水；甘露醇

[中图分类号] R651 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0063-03

[Abstract] Objective To study the effect of hypertonic saline and mannitol in treatment of intracranial hypertension after the hypertensive cerebral hemorrhage surgery. Methods 50 cases of patients with intracranial hypertension after the hypertensive cerebral hemorrhage surgery admitted and treated in our hospital from July 2014 to July 2016 were randomly selected and randomly divided into two groups with 25 cases in each， the control group were treated with mannitol， while the research group were treated with hypertonic saline， and the intracranial decompression effect， decompression onset time， decompression continuous time and serum natrium level were compared between the two groups were compared， and the nerve function defect score before and after treatment was observed and recorded and compared. Results The total effective rate in the research group and in the control group was respectively 84% and 80%， the decompression onset time in the research group and in the control group was respectively （24.32±4.73）min and （23.99±4.26）min， and the decompression continuous time in the research group and in the control group was respectively（4.56±0.53）min and （3.54±0.45）min， and the serum natrium level in the research group and in the control group was respectively （3.78±0.86） mmol/L and （3.35±0.83） mmol/L， before and after treatment， the nerve function defect score in the research group and in the control group were respectively （25.86±6.34）points and （20.54±4.12）points， （25.77±6.18）points and （20.78±4.26）points， and the differences in the total effective rate of decompression， decompression onset time and serum natrium level were not statistically significant（P>0.05）， but the decompression continuous time in the research group was obviously longer than that in the control group（P<0.05）， and the difference in the nerve function defect score before treatment between the two groups was not statistically significant（P>0.05）， and the score after treatment was improved（P<0.05）， but the difference between groups was not statistically significant（P>0.05）. Conclusion The effect of hypertonic saline and mannitol in treatment of intracranial hypertension after the hypertensive cerebral hemorrhage surgery is the same， but the continuous time of intracranial decompression of hypertonic saline is longer， which is worth reference.

[Key words] Hypertensive cerebral hemorrhage； Postoperative intracranial hypertension； Hypertonic saline； Mannitol

高血压脑出血是急性脑血管疾病比较常见与严重的类型，有着疾病快速、病情凶险等特点，在中老年人群中好发，也是导致他们死亡最为主要的原因之一[1]。高……