| ObjectiveThis study aims to observe the time for delay the intracranial pressure rebound with hydroxyethyl starch Sodium Chloride 130/0.4 joint mannitol in patients with traumatic brain edema, and in order to provide a theoretical basis for the clinical treatment in patients with traumatic brain edema.MethodWe Select 60 cases with strict inclusion criteria and exclusion criteria between 2012 and 2013 in Dong E Xian people’s hospital because of severe traumatic brain injury. All of the patients were treated in order to keep the balance of oxygen, water and electricity, prevent infection and gastrointestinal stress ulcer. The cases were randomly divided into observation group (mannitol group joint HES130/0.4) and the control group (mannitol combined with 5% glucose solution. We recorded Glasgow coma (G C S) score before treatment while recorded the level of plasma osmotic pressure and intracranial pressure detector and the mean arterial pressurel5 min,30 min, after 1 h,1.5 h and 2 h after being treated.And calculate the cerebral perfusion pressure. Using t test, analysis of variance and chi-square statistic method, using the SPSS 17.0 statistical software to the experimental results were analyzed.ResultBefore the treatment, the control group and the experimental group in the observation of the number of cases, no differences on gender, age, and Glasgow coma scale, P> 0.05). Compared with the before treatment, medicine control group and experimental group each time point after intracranial pressure were significantly lower, cerebral perfusion pressure were significantly elevated, P< 0.05); And the experimental group and control group intracranial pressure are within 30 minutes after medication to the lowest, in the two groups after 60 minutes intracranial pressure presents the bounce phenomenon, and gradually increased, But compared with the control group, experimental group the treatment of intracranial pressure was significantly lower than control group, P< 0.05); Before treatment, the experimental group and control group in blood plasma osmotic pressure has not difference,P> 0.05); Compared with before treatment, the plasma osmolality of the control group was significantly higher at 15 minutes,P<0.05, no significant difference in 90 minutes after administration and 120 minutes, P> 0.05; In the control group,compared with 15 minutes after the drug there is no significant changes in plasma osmolality at 30 minutes and 60 minutes,P＞0.05, but the osmotic pressure decreased significantly at 90 minutes and 120 minutes, P<0.05.There is no difference at 90 minutes and 120 minutes in plasma osmolality change,P> 0.05. Compared with 15 minutes after treatment, there is no statistically significant change in the experimental group,P> 0.05 at 90 minutes after treatment at plasma osmolality.ConclusionIn the ages of 30-60 years old, Glass score is between 3 to 8 points of patients with severe craniocerebral trauma with brain edema.Mannitol combined HSH130/0.4 have a better dehydration effect than mannitol in the patients with brain edema after TBI. And mannitol combined HSH 130/0.4 Can reduce ICP much more than that of mannitol combined 5% glucose solution stably and persistently. |
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