甘露醇和高渗盐水治疗外伤性脑水肿合并颅内高压的疗效  

Comparison of mannitol with hypertonic saline in treatment of traumatic brain edema associated with intracranial hypertension

作　　者：毛霄鹏[1] 冯东侠[2] 叶富华[2] 陈罡[2] 

机构地区：[1]东南大学临床医学院,南京210009 [2]东南大学微侵袭神经外科研究所

出　　处：《江苏医药》2007年第5期452-454,共3页Jiangsu Medical Journal

摘　　要：目的比较3%高渗盐水和20%甘露醇治疗外伤性脑水肿合并颅内高压的疗效。方法14例重型颅脑外伤患者开颅减压术后,每位患者随机分别接受两次3%高渗盐水和20%甘露醇的降颅压治疗。用药后6h内观察颅内压(ICP)、平均动脉压(MAP)、中心静脉压(CVP)以及血钠浓度和血浆渗透压的变化。结果3%高渗盐水和20%甘露醇两者均可显著降低颅内压(P<0·05),但3%高渗盐水作用持续时间较20%甘露醇长(P<0·05)。结论3%高渗盐水与20%甘露醇均可迅速降低颅内压。3%高渗盐水持续时间比20%甘露醇更长,可作为降低颅内压的一线治疗药物。Objective To compare the clinical efficacy of 3% hypertonic saline（HS） with 20% mannitol in reducing intracranial hypertension due to traumatic brain edema. Methods Each of fourteen severe head-injured patients received decompressive procedure was randomly received twice 3 HS solution and 20% mannitol treatments. Intracranial pressure （ICP）, mean arterial pressure （MAP）, cerebral perfusion pressure （CPP）, serum sodium and osmolality were continuously monitored within 6 hours. The nonparametric Wilcoxon＇s signed-rank test was used to analyze the data. Results Both 20%mannitol and 3%HS were effective in reducing ICP. 3% HS had a longer duration of action than mannitol （P〈0. 05）. Conclusion A bolus infusion of 3% HS or 20% mannitol can rapidly decrease ICP in patients with traumatic brain edema. 3% HS has a longer duration of action in reducing ICP and could be as the first-line therapeutic choice in managing intracranial hypertension after traumatic brain edema.

关 键 词：高渗盐水 甘露醇 颅内压 颅脑外伤 

分 类 号：R54[医药卫生—心血管疾病]