中小量高血压脑出血早期应用半量甘露醇与针刺治疗的疗效观察  

Low Dose of Mannitol with Acupuncture for Hypertensive Cerebral Hemorrhage

作　　者：李涛[1] 田桂杰[1] 张蓝[1] 魏国威[1] 马倩[1] 韩景献[1] 

机构地区：[1]天津中医学院第一附属医院

出　　处：《中西医结合心脑血管病杂志》2006年第11期960-961,共2页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨半量甘露醇与针刺对中小量高血压脑出血早期血肿扩大、临床疗效的影响及如何正确使用甘露醇。方法选取高血压幕上非丘脑出血、颅压增高不突出、发病6h内、血肿量<50mL的病人60例,将24h内应用20%甘露醇250mL者作为常规A组(30例),150mL者为半常规B组(30例),B组10d后再分为C组、D组各15例,C组为半常规未针刺组,D组为半常规针刺组。48h^72h复查脑CT,血肿增大33%为血肿早期扩大,分析早期应用甘露醇对血肿扩大的影响;对C组、D组治疗20d后进行神经功能缺损评分及临床疗效对照比较。结果常规A组发生血肿扩大11例,B组3例,A组与B组血肿扩大比较有统计学意义。神经功能评分及临床疗效比较,A组与B组无统计学意义;C组与D组有统计学意义。结论中小量脑出血病人发病24h内不适当应用甘露醇可增加早期血肿发生率,使病情加重;半量甘露醇配合针刺治疗中小量高血压脑出血临床疗效显著。Objective To study the influence of half dose of mannitol with acupuncture on early hematoma in patients （pts） with medium and minimum cerebral hemorrhage. Methods Sixty patients （pts） with non- thalamic cerebral hemorrhage, light intracranial hypertension and volume of hematoma less than 50 mL were randomly divided into group A treated with mannitol （n = 30）, group B treated with half dose of mannitol （n = 30）, group C （ n = 15, from group B, 10 days later） and group D treated with half dose of mannitol and acupuncture （ n = 15, from a group B, 10 days later）. If the volume of hematoma increased by 33 % by cranial CT, it should be considered as early enlargement of hematoma. Results Ha matoma enlarged in 11 pts in group A, 3 pts in group B. Nerve function defect was similar in group A and B. It was different in group C and D, Conclusion Improper use of mannitol within 24 h in pts with medium and minimum cerebral hemorrhage might increase the incidence of early enlargement of hematoma. Half dose of mannitol with acupuncture in pts with medium and minimum cerebral hemorrhage was effective.

关 键 词：高血压 脑出血 甘露醇 针刺 疗法 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R245.3[医药卫生—临床医学]