Analysis Of Hypertonic(3%) Saline In The Treatment Of Newborn With Intracranial Hypertension

Objective:To explore the clinical efficacy of3%NaCl on cerebral edema and intracranial hypertension in neonate.Methods:The prospective randomized control trial included54neonates of intracranial hypertension whom were randomly divided into20%mannitol treatment group(20%mannitol group, n=26) and3%NaCl treatment group(3%NaCl group, n=28). Intracranial pressure was detected in all the patients by lumbar puncture before treatment and5days after treatment (12hours after treatment at the fifth day) and cerebrospinal fluid was collected for routine examination, biochemical analysis and culture test. At the same time, the venous blood was obtained for testing serum sodium, serum chloride and serum osmolality change. Our aim is to investigate the effect of reducing cranial hypertension, the final efficacy and staying hospital days in the two groups. Meanwhile, the changes of TNF-a, IL-1and IL-10in cerebrospinal fluid before and after treatment were observed in some infectious brain edema patients.Results:1:The ICP before treatment in both3%NaCl group and20%mannitol group were abnormally high, and there was no significantly difference between the two groups (P>0.05). The ICP was significantly decreased after the treatment in both groups (P<0.05). The curative effect of3%NaCl was better than20%mannitol in reducing cranial hypertension, and the total effective rates of3%NaCl was significantly higher than that of20%mannitol after5days treatment.2. the CSF chloride concentration and serum chloride concentration were normal in both groups before treatment, there was no significantly difference between the two groups (P>0.05) After treatment, the serum chloride concentration in20%mannitol group was significantly lower than before it was treatment (P<0.05, while this was absent in3%NaCl group (P>0.05, and the serum chloride concentration in3%NaCl group was significantly higher than in20%mannitol group after treatment (P<0.01)3. There was no significantly difference in the final efficacy and duration of hospitalization between the two groups (P>0.05)4. The result of the clinical efficacy analysis of44cases of infectious brain edema intracranial hypertension neonates was the same according to the total results.5. There was no significantly difference in the IL-1、TNF-α or IL-10contents of cerebrospinal fluid in infectious brain edema intracranial hypertension patients between the two groups. In both groups, the IL-1contents of cerebrospinal fluid were obviously lower after treatment; while there were no significantly difference in the TNF-α or IL-10contents of cerebrospinal fluid after treatment (P>0.05), but the TNF-a contents in3%NaCl group was obviously lower than in the20%mannitol group (P<0.05)Conclusion:1.3%NaCl is effective in curing the cerebral edema and intracranial hypertension in neonate, and its effect of reducing cranial hypertension is better than20%mannitol.2.3%NaCl has no effect on the serum sodium, serum chloride or serum osmolality in intracranial hypertension neonates, while20%mannitol could reduce the serum chloride contents.3. The effect of3%NaCl in inhibiting the expression of proinflammatory factor (TNF-α、IL-1) is better than20%mannitol.