COMPARATIVE ANAL YSIS OF THE METHODS OF CORRECTION OF HYPERNATREMIA IN NEUROSURGERY PATIENTS

Abstract

The purpose of research is to conduct a comparative analysis of methods for correcting hypernatremia in patients with brain tumors and stroke hematomas in the early postoperative period by using a solution of hypotonic sodium chloride and using solution of sterofundin. Materials and methods: 93 patients with stroke hematoma (n=68) and brain tumor (n=25) with hypernatremia in the early postoperative period were divided into two groups «A» (n=52) and «В» (n=41). A 0,45% solution of sodium chloride was used as a correction for hypernatremia in group «A». The solution of sterofundin was used in group «В». To assess the effectiveness of treatment methods were taken into account normalization and the rate of correction of blood sodium levels. The target value was to achieve the level of sodium plasma in the range of 135-145 mmol/L. The non-parametric Mann-Whitney U-test was used for statistical analysis. Statistically significant changes were taken at p<0,05. Results and discussion: a comparative analysis of the dynamics of sodium levels showed significant differences (p<0,05) in the content of this electrolyte in the blood before surgery and in the early postoperative period (before correction of hypernatremia). Intergroup comparative analysis of the dynamics of the sodium level did not reveal statistically significant differences between the groups (p>0,05). However, sterofundin had an advantage in the rate of sodium reduction. The use of sterofundin reduced the level of sodium to target values by 24 hours faster than 0,45% sodium chloride solution. Conclusions: 1) the sodium level corresponded to normal values in patients before surgery (p<0,05); 2) the use of sterofundin reduced the sodium level to normal in 76,9% of patients by the end of the first day and by the beginning of the second day. When using 0,45% solution of sodium chloride a decrease in sodium to normal was observed in 78,3% of patients on the third day of the postoperative period; 3) the use of sterofundin solution for the correction of hypernatremia in the early postoperative period had a slight advantage over 0,45% sodium chloride solution in the rate of sodium reduction.