大剂量地塞米松在防治重型颅脑伤术后脑水肿的疗效评价

被引:17
作者
朱诚
张光霁
杨中坚
卢亦成
张晓鹏
袁绍纪
张叔辰
机构
[1] 第二军医大学长征医院神经外科
[2] 济南军区总医院神经外科
关键词
重型颅脑伤; 地塞米松; 脑水肿;
D O I
暂无
中图分类号
学科分类号
摘要
选择Glasgow昏迷评分8分以下、伤后6小时内入院的颅脑伤病人83例,随机分为应用地塞米松5mg/kg体重的大剂量组(51例)和0.5mg/kg的常规剂量组(32例)。发现大剂量组存活率为80.39%,小剂量组为43.75%;存活者恢复到清醒(GCS 15分)的天数:大剂量组6.18±2.68天、常规量组14.71±12.75天;P<0.01;大剂量组的颅内压在术后第5天降至1.77±0.7kPa(183.44±74.09mmH2O),常规量组则在第10天才降到1.8±0.78kPa(185.00±81.67mmH2O);术后第5天和30天CT复查,脑水肿程度较轻,脑软化灶很少;挫伤周围非功能区组织学检查显示,大剂量组的水肿程度、血脑屏障和细胞内结构的变化明显轻于常规量组。结果表明,应用大剂量地塞米松防治重型颅脑伤后的继发性脑水肿,疗效是确切的。
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页码:65 / 67+125 +125
页数:4
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