半剂量甘露醇对高血压性脑出血早期血肿影响的探讨  

Influence of half-dose mannitol on early hematoma in hypertensive cerebral hemorrhage

作　　者：张军[1] 

机构地区：[1]江苏省常熟市第一人民医院神经内科,江苏常熟215500

出　　处：《海南医学》2007年第7期12-13,共2页Hainan Medical Journal

摘　　要：目的探讨半剂量甘露醇对高血压性脑出血早期血肿扩大的影响。方法选择102例高血压性幕上性非丘脑脑出血,颅内高压不明显、发病6h内出血量<30ml的患者。将24h内应用半剂量甘露醇125ml者定为A组(34例),应用速尿者为B组(34例),24h内不应用任何脱水剂者为C组(34例)。48h复查头颅CT,血肿增大超过33%认为血肿扩大,分析24h内应用半剂量甘露醇对血肿扩大的影响。结果A组血肿扩大13例(38.2%),B组4例(11.8%),C组3例(8.8%),A组与B组、C组对比差异有显著性(P<0.05)。结论高血压性脑出血早期(24h内)应用半剂量甘露醇可能增加早期血肿扩大的发生率。即使半剂量甘露醇在高血压性脑出血早期也不宜盲目、仓促使用。Objective To probe into the influence of half-dose mannitol on early enlargement of hematoma in hypertensive cerebral hemorrhage. Methods 102 patients with hypertensive supratentorial nomthalamic cerebral hemorrhage and light intracranial hypertension, and with less than 30ml of hematoma volume determined by cranial CT within 6h after the onset were randomly divided into a group in which half-dose mannitol was used （n=34） or a group in which furosemide was used （n=34）, or a group rnannitol was not used （n=34）. Cranial CT was redone at 48h. If the volume of hemato increased by 33%, it was named early enlargement of hematoma. The influence of using mannitol within 24h after the onset on early enlargement of hematoma was analyzed. Results 13 （38.2%） patients in group A had early enlargement of hematoma, and 4 （11.8%） patients in group B and 3 （8.8%） patients in group C had early enlargement of hematoma. There was significant difference between them （P〈0.05）. Conclusions Use of half-dose mannitol within 24h after the onset may increase the incidence of early enlargement of hematoma in patients with hypertensive cerebral hemorrhage within 24h after the onset. And half-dose mannitol should not be used blindly.

关 键 词：半剂量甘露醇 脑出血 速尿 

分 类 号：R743.34[医药卫生—神经病学与精神病学]