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目的探讨重型颅脑损伤(TBI)渗透性治疗新进展。方法将本院自2007年8月至2010年4月收治的80例重型TBI(GCS≤8分)分成2组,对照组40例采用常规经验性治疗,维持血钠值135～150mmol/L,试验组40例在明确监测血钠值、血浆渗透压值,并维持血钠值145～155mmol/L,渗透压值300～320mOsm/L,行渗透性治疗,观察两组患者按GOS预后评分评定预后及影像学差异。结果试验组预后情况明显优于对照组,差异有统计学意义(P<0.05),且影像学也有明显差异。结论在明确监测血钠值,血浆渗透压基础上合理进行渗透性治疗,能有效改善重型TBI预后。
Objective To explore the new progress in the treatment of severe traumatic brain injury (TBI). Methods Eighty patients with severe TBI (GCS≤8) admitted from August 2007 to April 2010 in our hospital were divided into two groups. The control group of 40 patients were treated with routine empirical therapy to maintain the serum sodium level of 135 ~ 150mmol / L, 40 patients in the experimental group were monitored for serum sodium and plasma osmolality, maintained the serum sodium value of 145 ~ 155mmol / L, and osmotic pressure of 300 ~ 320mOsm / L, and treated with osmotic treatment. The GOS prognostic score Prognosis and imaging differences. Results The prognosis of the experimental group was significantly better than the control group, the difference was statistically significant (P <0.05), and imaging were also significantly different. Conclusion The reasonable treatment of permeability based on the definite monitoring of serum sodium and plasma osmotic pressure can effectively improve the prognosis of severe TBI.