闪光视觉诱发电位监测甘露醇降颅压效果的临床研究  

Clinical observation of mannitol therapeutic treatment on high intracranial pressure patients by flash visual evoked potentials

作　　者：谭戈[1] 周冀英[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,400016

出　　处：《中华神经科杂志》2006年第4期255-257,共3页Chinese Journal of Neurology

基　　金：重庆市卫生局重点资助项目(99-1001);重庆市卫生局资助项目(00-2028)

摘　　要：目的 利用闪光视觉诱发电位监测颅内高压患者颅压水平,研究降颅压效果与甘露醇用量以及其他影响因素的关系.方法 选择60例颅内高压患者,应用NIP-200型无创颅内压监测仪监测患者每日颅压,计算最高颅压与最低颅压间的差值（降颅压效果）,采用多元逐步回归方法分析降颅压效果与性别,年龄,最高颅压时的心率、血压以及降至最低颅压时甘露醇总用量的关系.结果 60例患者最低颅压平均值为（213.4±66.8） mm H2O （83.5～364.5 mm H2O）, 患者的颅压水平从入院至最低值时甘露醇总用量的平均值为（1870.8±861.9） ml（375～4000 ml）.降颅压效果与最高颅压时的血压（舒张压和收缩压）和心率无相关性（P＞0.05）,与性别、年龄显著相关（P＜0.05）,与甘露醇用量显著相关（P＜0.01）.结论 甘露醇有明显的降颅压作用,但是用到一定的剂量后,便不再有降颅压作用.女性患者比男性患者降颅压的效果好.患者年龄越小,降颅压效果越好.Objective To study the dose-dependent effects of mannitol and other factors on decreasing intracranial pressure using flash visual evoked potentials （fVEP）. Methods Sixty patients with elevated intracranial pressure were chosen in this study. Their intracranial pressure was monitored daily by NIP-200 noninvasive intracranial pressure apparatus. The variance between the highest intracranial pressure and the lowest intracranial pressure （the effect of decreasing intracranial pressure）, and the corresponding mannitol dose, were recorded respectively. The gender, age, heart rate and blood pressure in the highest intracranial pressure were also recorded. These data were applied for multivariate regression analysis. Results The average value of the lowest intracranial pressure for the 60 subjects were （213.4 ± 66. 8 ） mm H2O （83.5-364. 5 mm H2O）. The average total does of mannitol from the patients＇ hospital admission till the time of the lowest intracranial pressure were （1870. 8 ± 861.9） ml （375-4000 ml）. The reduction of intracrardal pressure and the heart rate or blood pressure in patients with the highest intracranial pressure didn＇t reach statistic significance （P 〉 0. 05 ）. However, the reduction of intracranial pressure were gender and age dependent （P 〈 0. 05 ）, as well as mannitol doses dependent in the period of decreasing intracranial pressure （ P 〈 0. 01 ）. Conclusions Mannitol has evident effect of decreasing intracranial pressure in a certain dose range. Female patients respond better to mannitol in decreasing intracranial pressure than male do, and the young patients do better than the elders, too.

关 键 词：诱发电位 视觉 颅内高压 甘露醇 

分 类 号：R741[医药卫生—神经病学与精神病学]