Abstract：Objective: To explore and compare the clinical efficacy of 3% hypertonic saline (HTS) and 20% mannitol (MT) in the treatment of severe craniocerebral injury with intracranial hypertension. Methods: A total of 100 patients with severe craniocerebral injury complicated with intracranial hypertension diagnosed and treated in our hospital from January 2018 to February 2019 were selected as the study objects and divided into treatment group and control group according to the random number table method, with 50 cases in each group. 3% HTS was administered to the treatment group and 20% MT was administered to the control group. The magnitude and duration of ICP decline before and after treatment were compared between the two groups, and the changes of MAP, CVP, CPP, serum sodium and plasma osmotic pressure at different times and the complications after treatment were recorded. Results: Repeated measures of variance analysis showed that the interaction effects of ICP, MAP, CPP, serum sodium and plasma osmotic pressure in the two groups were statistically significant at the time point, between the groups, and between the time point and the group (P<0.05), and the interaction effects of CVP were statistically significant at the time point and the group (P<0.05).After 1, 3 and 6 h of administration, ICP in the treatment group was lower than that in the control group, and MAP, CVP, CPP, serum sodium and plasma osmotic pressure were higher than those in the control group, with statistically significant differences (P<0.05).The other two groups were accompanied by cerebral infarction, delayed intracranial hematoma, diffuse brain swelling and other complications, the overall incidence of the treatment group was 6.00%, the control group was 14.00%, and the difference between the two groups was not statistically significant (χ2=1.778, P>0.05). Conclusion: 3% HTS can effectively reduce ICP in patients with severe craniocerebral injury, which is conducive to improving cerebral perfusion in patients, and has little impact on body circulation, which is worthy of clinical promotion.
宋梦娇, 张磊, 周美辉, 吴谦谦. 3%高渗盐水和20%甘露醇治疗重型颅脑损伤合并颅内高压的临床比较观察[J]. 河北医学, 2020, 26(7): 1170-1174.
SONG Mengjiao, ZHANG Lei, ZHOU meihui, et al. Clinical Comparison of 3% Hypertonic Saline and 20% Mannitol in the Treatment of Severe Craniocerebral Injury with Intracranial Hypertension. HeBei Med, 2020, 26(7): 1170-1174.
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2020, Vol. 26 
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