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3%高渗盐水在儿童颅内高压中的应用效果(1)
http://www.100md.com 2019年6月15日 《中国当代医药》 2019年第17期
     [摘要]目的 探討3%高渗盐水及20%甘露醇在儿童颅内高压中的应用效果。方法 收集2016年7月~2018年12月我院收治的44例颅内高压患儿的临床资料,按入组顺序的不同分为观察组和对照组,每组各22例。观察组使用3%的高渗盐水治疗,对照组使用20%的甘露醇治疗,其余治疗根据具体情况而定。比较两组的降颅内压效果、最终疗效、血清中血清钠及渗透压和住院时间。结果 两组患儿治疗前的颅内压水平比较,差异无统计学意义(P>0.05);两组患儿治疗后的颅内压水平低于治疗前,差异有统计学意义(P<0.05);观察组患儿治疗后的颅内压水平低于对照组,差异有统计学意义(P<0.05)。观察组患儿的治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。两组患儿治疗前的血清钠及血清渗透压水平比较,差异无统计学意义(P>0.05);治疗3 d后,对照组患儿的血清钠水平低于治疗前,血浆渗透压水平高于治疗前,差异均有统计学意义(P<0.05);观察组患儿的血清钠和血浆渗透压水平高于治疗前及对照组,差异均有统计学意义(P<0.05);两组患儿的住院时间比较,差异无统计学意义(P>0.05)。结论 3%高渗盐水对儿童颅内高压患儿降颅压的作用优于20%甘露醇,且不会降低血清钠浓度及血清渗透压,值得临床推广使用。

    [关键词]3%高渗盐水;儿童;颅内高压

    [中图分类号] R742 [文献标识码] A [文章编号] 1674-4721(2019)6(b)-0082-04

    [Abstract] Objective To explore the application effect of 3% hypertonic saline and 20% Mannitol in children with intracranial hypertension. Methods The clinical data of 44 children with intracranial hypertension admitted to our hospital from July 2016 to December 2018 were collected and divided into observation group and control group according to the order of admission, 22 cases in each group. The observation group was treated with 3% hypertonic saline, while the control group was treated with 20% Mannitol, the rest of the treatment depended on the specific situation. The effect of reducing intracranial pressure, the final effect, serum sodium, osmotic pressure and hospitalization time were compared between the two groups. Results There was no significant difference in intracranial pressure between the two groups before treatment (P>0.05). The intracranial pressure level of the two groups after treatment were lower than those before treatment, the differences were statistically significant (P<0.05). The level of intracranial pressure in the observation group after treatment was lower than that in the control group, the difference was statistically significant (P<0.05). The total effective rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05). There was no significant difference in serum sodium and osmotic pressure between the two groups before treatment (P>0.05). After 3 days of treatment, the level of serum sodium in the control group was lower than that before treatment, and the level of plasma osmotic pressure was higher than that before treatment, the differences were statistically significant (P<0.05). The levels of serum sodium and plasma osmotic pressure in the observation group were higher than those before treatment and in the control group, the differences were statistically significant (P<0.05). There was no significant difference in hospitalization time between the two groups (P>0.05). Conclusion 3% hypertonic saline is superior to 20% mannitol in lowering intracranial pressure in children with intracranial hypertension, and does not reduce serum sodium concentration and osmotic pressure, which is worthy of clinical application., http://www.100md.com(戴本启 林雪 张志梅)
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