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Objective To explore the application value of the pulse index continuous cardiac output monitoring technology (PICCO) in treating severe craniocerebral injury complicating neurogenic pulmonary edema(NPE).Methods Fifty-two cases of severe craniocerebral injury complicating NPE in the intensive care medicine department of this hospital were divided into the observation group and control group,26 cases in each group.The control group adopted the routine neurological treatment measures and guided the fluid infusion by monitoring the central venous pressure(CVP),while on the basis of the control group,the treatment group monitored the hemodynamics by PICCO and guided the fluid management according to the cardiac index(CI),extravascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),global end diastolic volume index(GEDVI) and intrathoracic blood volume index(ITBVI).The clinical curative effects,hemodynamic indexes,intracranial pressure(ICP),average daily infusion volume,mechanical ventilation time,hospital stay and GOS prognosis evaluation were compared between the two groups.Results The improvement of the heart rate(HR),mean arterial pressure (MAP),oxygenation index(PaO2/FiO2),ICP and other indicators in the observation group was more obvious than that in the control group(P＜0.05);the CVP rise in the control group was more obvious(P＜0.05);CI,EVLWI,PVPI,GEDVI and ITBVI in the observation group were improved and stabilized;the daily average infusion amount,mechanical ventilation time and hospital stay in the observation group were less than those in the control group(P＜0.05);but the good prognosis rate and mortality rate had no significant difference between the two groups(P＞0.05).Conclusion PICCO can better conduct the liquid management,improves the clinical symptoms,shortens the mechanical ventilation time and hospitalization stay,but the results show no significant improvement in prognosis and mortality.
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5.Negative nitrogen balance nutritional index in the study group were significantly better than that of the control group(P
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Objective To reseach the effects of diazepam under different cerebral temperature on the concentration of glutamate(Glu), ?-aminobutyric acid (GABA), superoxide dismutase (SOD), glutathione peroxidase(GSH-PX) and malonaldehyde(MDA) in cerebral ischemia tissue of rat. Methods The modle of cerebral middle artery occlusion reperfusion of rats was established to induce the target cerebral temperatue.The concentration of Glu, GABA, SOD, GSH-PX and MDA were detected in mild hyperthermia, ordinary temperature and subhypothermia groups respectively. Results (1)Compared with the sham-operation group under normal temperature,the concentration of Glu, MDA had increased obviously in the control group of focal cerebral ischemia and the group using diazepam under normal temperature (all P0.05),but the concentration of GABA had increased markedly in the groups of normal temperature using diazepam (P0.05).(3)Compared with the control group using diazepam under normal temperature,the concentration of Glu and MDA increased obviuosly(all P0.05).The concentration of Glu and MDA in the groups of hypothermia using diazepam was lower markedly (P