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脑外伤病人心钠素监测与体位护理 |
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于守香 杨文霞 江苏省南京市第一医院,南京 210006
摘要 应用放射免疫法检测30例清醒闭合型颅脑损伤病人的外周血心钠素(ANP),发现:病人受伤24 h内卧位和坐位时ANP值均显著升高,尤以坐位升高更加明显;受伤后1周,卧位和坐位时ANP值也显著升高,但坐位和卧位相比无显著差异。以上结果表明,脑外伤病人受伤早期ANP释放多,尤其坐位释放更多,心钠素具有强烈的利尿和利尿钠作用,有利于减轻脑水肿,为临床脑外伤病人采取头高位提供了理论依据。 关键词 脑外伤; 心钠素; 放射免疫; 体位护理
Determination of ANP in the Patients with Head Trauma and Postural Care
Yu Shouxiang Yang Wenxia Nanjing First Hospital of Jiangsu Province, Nanjing 210006
Abstract The level of peripheral blood ANP in 30 patients with sober closed head trauma was determined using radioimmunoassay. It was found that ANP level in lying and sitting positions was significantly increased in 24 h after head trauma, especially in sitting position. One week after head trauma, the level of ANP was also significantly increased in lying and sitting positions, but no statistical difference between them. The results suggested that in the early stage of head trauma ANP release was elevated, especially in stitting position. ANP had the strong therapeutic effect of diuresis and sodium diuretin and could alleviate brain edema, which might provide the theoretical foundation for the head traumatic patients with sitting position in clinically. Key words head trauma; ANP; radioimmunoassay; postural care
清醒闭合型颅脑损伤采取头高位是临床常用的体位,但尚缺乏一定的理论依据,作者测定脑外伤病人的外周血心钠素(ANP),旨在探讨ANP与脑外伤病人体位之间的关系,并从免疫学角度探讨头高位的理论依据。 1 资料与方法 1.1 检测对象:对照组为健康成人48例(为我院1997年新分配的工作人员),其中男19例,女29例,年龄17~32岁,平均22.58岁。观察组为1997年3~8月在我院脑外科住院的清醒闭合型脑外伤病人30例,其中男27例,女3例,年龄17~72岁,平均38岁。格拉斯哥昏迷计分(GCS)6~15分,平均14分。车祸伤23例,暴力伤5例,自行摔伤2例。诊断脑挫伤5例,硬膜下血肿3例,硬膜外血肿5例,蛛网膜下腔 出血2例,颅骨骨折3例,合并伤12例。收缩压12~20 kPa,平均15.9 kPa;舒张压8~12 kPa,平均9.9 kPa。均治愈出院。 1.2 方法:观察组病人分别于受伤24 h内和第7 d晨空腹平卧及坐位时用放射免疫法检测外周血ANP(试剂由北京北方免疫试剂研究所供给)。经统计学处理,组间资料比较采用t检验。 2 结果 2.1 对照组卧位时ANP值为(108.52±6.25) pg/ml,坐位时为(94.54±4.99) pg/ml;观察组病人受伤24 h内卧位时ANP值为(125.86±6.53) pg/ml,坐位时为(148.56±[1] [2] 下一页 上一个医学论文: 开颅术后高糖高渗非酮性昏迷病人的观察与护理 下一个医学论文: 糖尿病神经源性膀胱患者排尿功能训练效果观察
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