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目的探究血液净化对重症颅脑损伤合并高钠血症的临床疗效。方法选取我院自2013年2月~2016年2月收治的40例重型颅脑损伤合并高钠血症患者为研究对象,对出现高钠症的患者进行连续血液净化疗法。检测和记录患者治疗前后血钠浓度、心率、肌酐、尿素氮、血液渗透压、GCS评分,APPECHEⅡ评分和平均动脉压的指标。结果在实施血液净化的40例重症颅脑损伤患者中有13例(32.50%)死亡,21例(52.50%)痊愈,7例(17.50%)好转。患者在治疗后的血钠浓度和平均渗透压指标方面明显低于治疗前,动脉压则明显高于治疗前,差异具有统计学意义(P<0.05),但心率在治疗前后没有差异(P>0.05)。治疗后GCS评分,APPECHEⅡ评分,肌酐和尿素氮指标均明显低于治疗前,且差异具有统计学意义(P<0.05)。结论血液净化技术治疗重症颅脑损伤合并高钠血症具有良好的临床效果,能够逐步稳定生命体征,降低病死率,对改善临床疗效有重要意义。
Objective To investigate the clinical effect of blood purification on severe craniocerebral injury combined with hypernatremia. Methods Forty patients with severe craniocerebral injury and hypernatremia treated in our hospital from February 2013 to February 2016 were enrolled in this study. Continuous blood purification was performed in patients with hypernatremia. The serum sodium concentration, heart rate, creatinine, blood urea nitrogen, blood pressure, GCS score, APPECHEⅡscore and mean arterial pressure were measured and recorded before and after treatment. Results Thirty-three patients (32.50%) died of blood-purification in 40 patients with severe craniocerebral injury, 21 patients (52.50%) were cured and 7 patients (17.50%) were cured. The patients’ serum sodium concentration and mean osmotic pressure index after treatment were significantly lower than those before treatment. The arterial pressure was significantly higher than before treatment (P <0.05), but there was no difference in heart rate before and after treatment (P> 0.05). After treatment, GCS score, APPECHE Ⅱ score, creatinine and urea nitrogen index were significantly lower than before treatment, and the difference was statistically significant (P <0.05). Conclusion Blood purification has a good clinical effect in the treatment of severe craniocerebral injury with hypernatremia. It can stabilize the vital signs gradually and reduce the mortality, which is of great significance to improve the clinical efficacy.