高原脑水肿不同治疗方案的疗效比较及其规范化治疗初步探讨  

Three therapeutic regimens for high altitude cerebral edema:result comparison and preliminary study of standardized treatment

作　　者：闫春城[1] 李素芝[1] 王宇亮[1] 郑必海[1] 郑建保[1] 陈彬[2] 廖国云[1] 董学文[1] 杨定周[1] 鲁茸七林[1] 

机构地区：[1]西藏军区总医院高山病科,拉萨850007 [2]西藏军区总医院心脏内分泌科,拉萨850007

出　　处：《西南国防医药》2010年第7期774-777,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的比较高原脑水肿(high altitude cerebral edema,HACE)不同治疗方案之间疗效,初步探索高原脑水肿的规范化治疗方案。方法将60例HACE患者随机平均分为A、B、C组,A组给予吸氧、地塞米松、甘露醇、速尿治疗,B组给予吸氧、地塞米松、甘露醇、乙酰唑胺治疗,C组给予吸氧、β-七叶皂甙、甘露醇、速尿治疗,并对3组的疗效进行综合评价。结果从症状缓解时间、CT影像上脑水肿征象消失时间及住院时间比较,A组均显著低于B组和C组(P<0.01);3种治疗方案安全性比较,A组副作用及并发症发生率显著低于B组及C组(P<0.05)。结论吸氧、地塞米松、甘露醇、速尿方案具有安全、疗效显著的特点,可以作为高原脑水肿规范化治疗方案加以推广。Objective To explore a standardized therapeutic regimen for high altitude cerebral edema （HACE） through the comparison of therapeutic effects among different treatment plans. Methods 60 patients with HACE were randomly divided into group A, B and C. Group A was given oxygen inhalation, dexamethasone, mannitol and fursemide; group B was given oxygen inhalation, dexamethasone, mannitol and acetazolamide; group C was given oxygen inhalation, 13 aescin, mannitol and fursemide. Then the therapeutic effects of the three groups were appraised comprehensively. Results The relief time of symptoms, extinction time of cerebral edema in CT and hospital day were significantly shorter in group A than those in group B and C（P 〈0.01 ）. In addition,the incidence of side effects and complications were significantly lower in group A than those in group B and C（P 〈 0.05 ）. Conclusion The regimen made up of oxygen inhalation, dexamethasone, mannitol and tursemide is safe and highly effective. It can be used as the standard therapeutic regimen for HACE.

关 键 词：高原脑水肿 治疗 规范化 

分 类 号：R594.3[医药卫生—内科学]