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目的 探讨 2 3 4 %高渗盐水治疗颅内高压的疗效及副作用。方法 对 2 0名昏迷的、有侧脑室引流指征的脑出血患者进行共 4 6例次降颅内高压试验。静脉推注 2 3 4 %高渗盐水 30ml。用药前至用药后6h内 ,持续监测颅内压 (ICP)、平均动脉压 (MAP)、中心静脉压 (CVP)、脑灌注压 (CPP)、血生化。结果 用药后 (2 8 8± 2 0 7)min ,ICP从 (4 1± 1 5 )kPa降至 (1 6± 0 7)kPa (P <0 0 1) ;其中 39例次的ICP降幅≥ 5 0 %。用药后 (4 5± 1 4 )hICP升到用药前水平。用药后 30min ,MAP降低 (P <0 0 5 ) ,CPP升高 (P <0 0 5 )。CVP、血生化以及渗透压稳定。结论 2 3 4 %高渗盐水能在不降低CPP的情况下 ,于2 8 8min内使颅内压下降 6 2 % ,持续作用近 4 5h。
Objective To investigate the curative effect and side effects of intracranial hypertension treated with 2 34% hypertonic saline. Methods A total of 46 cases of intracranial hypertension were performed in 20 comatose patients with ICH indications of lateral ventricle drainage. Intravenous injection of 23 3% hypertonic saline 30ml. The intracranial pressure (ICP), mean arterial pressure (MAP), central venous pressure (CVP), cerebral perfusion pressure (CPP) and blood biochemistry were continuously monitored within 6 hours before treatment. Results The ICP decreased from (41 ± 1 5) kPa to (16 ± 0 7) kPa (2800 ± 277) min after treatment (P <0.01). The ICP of 39 cases decreased more than 50%. After treatment (4 5 ± 1 4) hICP rose to pre-drug levels. After 30min, MAP decreased (P <0.05) and CPP increased (P <0.05). CVP, blood biochemistry and osmotic pressure stability. Conclusions 23.4% of hypertonic saline can reduce intracranial pressure by 62% within 288min without any decrease in CPP, and last for about 45h.