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高渗氯化钠羟乙基淀粉40对颅脑内肿瘤切除术颅内压的影响 被引量：2

Effects of hypertonic sodium chloride hydroxyethyl starch 40 on intracranial pressure in brain tumorectomy
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摘要 目的比较高渗氯化钠羟乙基淀粉40(HSH40)和20%甘露醇对颅内肿瘤切除术颅内压(ICP)的影响。方法择期颅内肿瘤切除术患者60例,随机均分为HSH40组(H组)和甘露醇组(M组)。麻醉前行L3～4蛛网膜下腔穿刺置管术,接压力传感器监测ICP,麻醉后按4ml/kg量输入HSH40(H组)或20%甘露醇(M组),30min输完。记录开始输入即刻(T0)、输完即刻(T1)、输完后15min(T2)、30min(T3)、60min(T4)和120min(T5)时的MAP、CVP、ICP、尿量和动脉血气分析结果。结果两组T2～T5时ICP显著低于T0时(P<0.05)。H组CVP在T2～T4时显著高于T0时和M组(P<0.05)。H组Na+在T2、T3时显著高于T0时和M组。H组K+在T2和T3时显著低于T0时,且T2时H组低于M组。H组T3和T4时PaO2显著高于T0时,且T3时PaO2显著高于M组(P<0.05)。M组T2～T5时尿量显著多于H组(P<0.05)。结论 HSH40和甘露醇均能有效降低ICP,但HSH40更能维持围术期血流动力学稳定。 Objective To compare the effects of hypertonic sodium chloride hydroxyethyl starch 40（HSH40）and 20% mannitol on intracranial pressure（ICP）during brain tumorectomy.Methods Sixty patients undergoing brain tumorectomy were randomly divided into two groups with 30 cases each.HSH40 4 ml/kg（group H）and 20% mannitol 4 ml/kg（group M）were infused in 30 min after anesthesia induction.Before induction of anesthesia,ICP was measured by subarachnoid cathterization.Mean arterial pressure（MAP）,central venous pressure（CVP）,urinary volume,ICP and arterial blood gas analysis were measured and recorded before infusion（T0）,at the end of infusion（T1）,15 min（T2）,30 min（T3）,60 min（T4）and 120 min（T5）after infusion.Results ICP was decreased significantly at T2-T5 in two groups.CVP at T2-T4 in group H was increased significantly than that at T0 and that in group M.Plasma Na^＋ concentration at T2 and T3 of group H was increased significantly than that at T0 and that in group M.Plasma K^＋ concentration at T2 and T3 in group H was decreased significantly than that at T0 and that in group M.Arterial oxygen pressure（PaO2）at T3 and T4 in group H was increased significantly than that at T0 and that in group M.The urinary volume at T2-T5 in group H was increased significantly than that in group M.Conclusion Both HSH40 and 20% mannitol can ruduce ICP effectively,but HSH40 can maintain the haemodynamics more stable.
作者 郭锐 彭道珍 叶军明 邓云菱 王力峰
机构地区 赣南医学院第一附属医院麻醉科
出处 《临床麻醉学杂志》 CAS CSCD 北大核心 2011年第1期15-17,共3页 Journal of Clinical Anesthesiology
关键词 高渗氯化钠羟乙基淀粉40 甘露醇 颅内压 Hypertonic sodium chloride hydroxyethyl starch 40 Mannitol Intracranial pressure
分类号 R739.41 [医药卫生—肿瘤]
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参考文献6

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二级参考文献9

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临床麻醉学杂志
2011年 第1期

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