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目的:研究高渗氯化钠羟乙基淀粉40注射液(HSH40)联合甘露醇救治颅内高压合并失血性休克患者的临床疗效。方法:选取本院2013年2月至2015年3月60例颅脑外伤合并失血性休克患者为研究对象,随机分为观察组和对照组,每组30例。观察组采用HSH40联合甘露醇,对照组采用复方乳酸钠联合甘露醇。比较两组患者休克症状、颅内压变化以及血浆浓度。结果:观察组输注30 min后的中心静脉压为(7.65±0.33)cm H2O显著高于对照组的(4.57±0.22)cm H2O(P<0.05),观察组输注30 min后的颅内压为(18.6±1.45)mm Hg显著低于对照组的(23.28±1.61)mm Hg(P<0.05)。观察组输注30 min后的血钠、血氯分别为(145.31±4.22)mmol/L、(103.13±2.08)mmol/L显著高于对照组的(140.62±1.04)mmol/L、(99.23±1.07)mmol/L(P<0.05)。结论:HSH40联合甘露醇在颅内高压合并失血性休克患者的救治中效果显著,降低颅内压同时能及时纠正休克症状。
Objective: To study the clinical effect of hypertonic sodium chloride hydroxyethyl starch 40 injection (HSH40) combined with mannitol in the treatment of patients with intracranial hypertension and hemorrhagic shock. Methods: From February 2013 to March 2015, 60 patients with craniocerebral trauma combined with hemorrhagic shock were selected and randomly divided into observation group and control group, with 30 cases in each group. Observation group using HSH40 combined with mannitol, the control group with compound sodium lactate mannitol. Shock symptoms, changes in intracranial pressure and plasma concentrations were compared between the two groups. Results: The central venous pressure of the observation group after 30 min of infusion was (7.65 ± 0.33) cm H2O significantly higher than that of the control group (4.57 ± 0.22) cm H2O (P0.05) Pressure was (18.6 ± 1.45) mm Hg, which was significantly lower than that of the control group (23.28 ± 1.61 mm Hg, P <0.05). Blood sodium and blood chlorine in observation group were (145.31 ± 4.22) mmol / L and (103.13 ± 2.08) mmol / L respectively, which were significantly higher than those in control group (140.62 ± 1.04 mmol / L, 99.23 ± 1.07) mmol / L (P <0.05). Conclusion: The effect of HSH40 combined with mannitol in the treatment of patients with intracranial hypertension combined with hemorrhagic shock is significant, reducing intracranial pressure and timely correcting shock symptoms.