For patients with cerebral edema and cranial hypertension, emphasizing on dehydration treatment has been a fixed concept for many years in China. Professor Yuan Xianrui, Director of Neurosurgery Department of Xiangya Hospital, started to implement the treatment method of replenishing while shedding to maintain the balance of water and electrolyte, maintaining the balance of crystals and colloid in the blood, and guaranteeing the energy and nutritional demand for the patients in the 90s of the last century, and after more than 10 years’ exploring and summarizing, he proposed the principle of comprehensive balanced treatment in China for the first time based on the predecessors. After more than 10 years of exploration and summarization, the principle of comprehensive and balanced treatment was proposed for the first time in China on the basis of the predecessors, and the clinical efficacy was remarkable, and the mortality rate dropped from more than 15% at that time to less than 2% now. Yuan Xianrui, Department of Neurosurgery, Xiangya Hospital, Central South University The patient, He, a 72-year-old woman from Xiangtan City, was diagnosed with right frontal lobe lesion after gamma knife treatment with tumor margin cerebral edema in a local hospital. Dehydration treatment according to the dogma of textbooks for many years, in the local admission has been given mannitol dehydration and symptomatic treatment, hospitalized for more than 20 days the condition not only did not improve, but also the emergence of concave edema of the limbs, lung infection, low potassium and sodium hypochlorhydria, hypoproteinemia, etc., the ward has been under the notice of the critical illness. on March 10, the transfer of Xiangya Hospital, the patient’s admission found that the patient’s body is frail, although the cerebral edema is obvious, but the There were obvious dehydration syndromes, such as hyponatremia and hypochlorhydria, vomiting, and fatigue. If dehydration is given at this time, the more dehydrated the patient is, the worse his condition will become, and the worse his condition will become, the more dehydrated he will become, thus forming a vicious circle. According to the principle of comprehensive balanced treatment proposed by Prof. Yuan Xianrui, we decisively stopped the use of dehydration drugs, rapidly replenished water and electrolytes, corrected the low blood sodium and potassium, supplemented plasma and albumin, so that the electrolyte and colloid in the body to achieve equilibrium, and at the same time, gave intravenous nutrition, supply of energy, treatment for 4 to 5 days, the spirit of the patient was obviously better, and basically can help the bed down to the ground to walk, the limbs of the edema was also obviously better, treatment for 10 days, after the patient After 10 days of treatment, the patient’s edema completely subsided, and he could get out of bed and move around, and he could take care of his own food and living, and he was discharged from the hospital with obvious improvement in his condition. For patients with cerebral hemorrhage and severe craniocerebral injury to reduce cerebral edema and intracranial pressure, osmotic dehydration is the first choice for clinical treatment. Among them, mannitol is the most widely used. The purpose of dehydration is firstly to reduce intracranial pressure; secondly, it is hoped to reduce the secondary damage of peripheral tissues caused by ischemia or hemorrhage; in addition, by correcting these factors, it is also possible to improve the perfusion of the tissues and thus improve the prognosis. According to the literature, the vast majority of patients were treated with mannitol for more than 1 week, 51% for more than 10 days, and 34.80% for more than 16 days. Cranial hypertension in patients with dehydration treatment is correct, but the application of dehydration medication is indicative, many hospitals in China, especially grassroots hospitals, dehydration treatment of patients has exceeded the normal range and greatly abused, head trauma, stroke or intracranial lesions of the patient indiscriminate, the application of dehydrating drugs until the patient is discharged from the hospital, and part of the patient due to excessive dehydration and aggravation of the disease. The condition of some patients was aggravated by over-hydration. In fact, the adverse effects caused by using dehydrating agents such as mannitol and tachycardia in large doses for a longer period of time and restricting the amount of water intake should not be ignored in the clinic, mainly electrolyte disorders, hypertonic coma, cardiac and renal impairment, and blood volume insufficiency. The principle of comprehensive balanced treatment proposed by Prof. Yuan Xianrui believes that the balance of the patient’s internal environment should be maintained when treatment is carried out, and these balances include the balance of water electrolytes, the balance of crystals and colloids in the blood, the balance of nutrients and energy, the balance of hormones, the balance of vital signs, etc. The human body is a balanced ecological environment, and it is the most important part of the human body. The human body is a balanced ecological environment, once the imbalance will be sick, and after the illness the doctor’s task is to restore the patient’s imbalance of the ecological environment, the treatment of Chinese medicine is very concerned about the balance of yin and yang, and the principle of treatment in Western medicine is also the same, for the cerebral edema, how much water is taken off how much water should be replenished in a timely manner, electrolytes are lost is a timely replenishment, such as the patient He due to right frontal lobe occupancy of the cerebral edema, the formation of intracranial pressure Like the patient He who had cerebral edema due to right frontal lobe occupancy, resulting in intracranial pressure elevation and difficulty in walking, if dehydration therapy is given purely, not only can it not achieve the purpose of treating cerebral edema, but also lead to electrolyte disorders and hypoalbuminemia, which induces limb edema. Prof. Yuan Xianrui’s group has discovered from more than 10 years’ exploration and thousands of cases’ treatment experience that giving patients comprehensive balanced treatment can rapidly correct the water-electrolyte imbalance, maintain the balance of blood colloid and crystal, greatly reduce the complications brought by the application of dehydrating drugs, and promote the recovery of patients. Prof. Yuan Xianrui and others pointed out that at present, through unremitting preaching, neurosurgeons, especially those who have undergone specialized training, have been able to pay full attention to the importance of water-electrolyte balance in treatment, but not enough attention has been paid to energy and nutritional balance, and only people with a higher level of professionalism have paid attention to colloidal balance in the blood and balance of hormones, etc. This requires a process. This requires a process, and only when comprehensive balanced treatment is emphasized will patients recover as quickly as possible. Prof. Yuan also suggested that for patients with high cranial pressure, if the internal balancing treatment fails to reduce the intracranial pressure effectively, surgical treatment should be carried out in time, such as debridement decompression surgery, so as to avoid causing brain hernia. Author：News Out：Xiangya Hospital Writer：Xie Mingxia [Correspondent] Wu Ximing http://news.its.csu.edu.cn/Archive/200904/20090429033246518.shtml