摘要
目的:探讨重型颅脑外伤患者急性期液体管理治疗的策略。方法:回顾性分析45例患者治疗监护过程中的临床资料。结果:本组存活25例,存活率为55%,死亡20例,病死率44%。患者多合并骨折及肺部损伤,24h入量及出量较大,大部分患者合并大量额外肾外液体丧失,丢失胶体成分多。入院时合并休克6例。入院时CVP低者占58%(26/45),入院血清总蛋白及白蛋白数值与第7d相比减少者占72%(28/39)。结论:存在体克、血容量不足的患者,必须24h内纠正休克,补足血容量,但应注意胶体液输入的量及时机、晶体液与胶体液比例分配,避免加重脑水肿、肺水肿。
Objective To study the strategy of liquid management for heavy cerebral injury patient in acute issue. Methods The clinical information in 45 patients were retrospectively analysed. Results Twenty-five cases survived,with the survival rate of 55%. And 20 patients died, with the fatality rate of 44%. Many patients were complicated with fracture and lung injury. The total input and output liquid measured in 24 hours were greater. Most of patients were complicated with plenty of extra liquid lost besides kidney, containing a large amount of colloid. During being hospitalized, 6 patients were complicated with shock and the low CVP took 58 %. Total albumen and serum albumin reduced compared the 1st day with 7th day,which took 72%. Conclusion Liquid management strategy is that shock and insufficient blood capacity must be corrected in 24 hours. But the quantity and the time of the input of colloid,and the proportion of crystal liquid to colloid liquid should be paid much attention to avoid aggravating encephaledema and pneumonedma.
出处
《实用诊断与治疗杂志》
2005年第4期244-246,共3页
Journal of Practical Diagnosis and Therapy
关键词
重型颅脑外伤
休克
液体复苏
晶胶比例
重症监护
Heavy cerebral injury
shock
liquid resuscitation
proportion of crystal liquid to colloid liquid
critical care
