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目的探讨重型颅脑损伤继发性脑水肿的补液方法。方法将120例重型颅脑损伤继发性脑水肿患者随机分为液体疗法组(A组)55例和传统疗法组(B组)65例。A组不限水、钠入量,按需补入,B组限水、钠入量,使病人处于轻度的脱水状态。结果2组在伤后一月内行格拉斯哥评分(GCS)比较,5 d后A组即优于B组,一月后行格拉斯哥治疗结果分级(GOS)评定,A组Ⅰ~Ⅲ级占30.9%,而B组占64.6%,2组差异有统计学意义(χ2=14.97,P<0.005),同时,A组并发症发生率明显低于B组。结论重型颅脑损伤继发性脑水肿采用充分补液,按需而入,能起到促进病人恢复、缩短病程、降低并发症、减少致残及死亡率。
Objective To investigate the method of rehydration of secondary cerebral edema in severe craniocerebral injury. Methods A total of 120 patients with severe brain injury secondary to cerebral edema were randomly divided into liquid therapy group (group A) 55 cases and traditional therapy group (group B) 65 cases. A group not limited to water, sodium intake, on-demand supplement, B group water, sodium intake, the patient in a mild dehydration state. Results The Glasgow score (GCS) was significantly higher in group A than in group B after 5 days. Group A was superior to group B after 5 days. Glasgow’s outcome was graded in group A after one month. Group Ⅰ-Ⅲ was 30.9% While group B accounted for 64.6%. The difference between the two groups was statistically significant (χ2 = 14.97, P <0.005). Meanwhile, the incidence of complications in group A was significantly lower than that in group B. Conclusion Secondary cerebral edema in severe craniocerebral injury with adequate rehydration, as needed, can play to promote patient recovery, shorten the course of the disease, reduce complications, reduce disability and mortality.