高血压脑出血早期应用甘露醇治疗的临床分析  

The Clinical Analysis of Mannitol Therapy for Early Stage of Patients with Hypertensive Cerebral Hemorrhage

作　　者：吴贵平[1] 沙龙金[1] 曾文胜[1] 王广斌[1] 曾鹏[1] 钟俊贤[1] 

机构地区：[1]中山大学附属东莞东华医院,广东东莞523220

出　　处：《河北医学》2012年第2期195-198,共4页Hebei Medicine

摘　　要：目的:探讨高血压脑出血早期应用甘露醇治疗的临床疗效和不良反应。方法:将我院收治高血压脑出血患者64例随机分为三组,A组20例,24h内给予甘露醇常规剂量250mL静脉点滴治疗,1次/(8-12)h;B组21例,患者24h内给予甘露醇半量125mL静脉点滴治疗,1次/(8-12)h;C组23例,发病后24h内未接受甘露醇治疗;三组其他治疗无差别。观察三组患者降颅压效果,神经系统功能缺损评分情况及血肌酐、血尿素氮变化。结果:A、B组患者降颅压疗效显著优于C组(P<0.01),B、C患者神经功能缺损评分低于A组(P<0.05),B、C两组患者神经功能缺损评分无显著差异(P>0.05)。治疗7d后A、B两组BUN、Cr明显升高,与治疗前相比有统计学差异(P<0.05),C组BUN、Cr值与治疗前无统计学差异(P>0.05),但B组患者BUN、Cr值低于A组(P<0.05)。结论:高血压脑出血早期应用甘露醇治疗可以有效降低患者颅内高压,半量甘露醇治疗可以减轻神经功能损害,对肾功能损伤较轻,是治疗高血压脑出血的合适剂量。Objective： To investigate the efficacy and adverse reactions of mannitol treatment of hypertensive cerebral hemorrhage.Method： 64 patients of hypertensive cerebral hemorrhage were randomly divided into three groups,A group,20 patients,were given regular doses of intravenous mannitol treatment,24h in 250mL;B group,21 patients,were given intravenous mannitol treatment half the amount of 125mL;C group,23 patients,were not receive mannitol;other treatment no difference.Observing the intracranial pressure lowering,neurological deficit scores and BUN,Cr changes.Result： The intracranial pressure effect of A,B group was significantly better than group C（P 0.01）,the neurological deficit score of B,C group were lower than group A（P 0.05）,B,C reducing the intracranial pressure in patients with treatment groups and neurological deficit score was no significant difference（P 0.05）.After treatment BUN,Cr of A,B group was significantly higher compared with before treatment were significantly different（P 0.05）,C group BUN,Cr values before treatment with no significant difference（P 0.05）,but group B patients with BUN,Cr is lower than that of group A（P 0.05）.Conclusion： Mannitol treatment can effectively reduce intracranial pressure in patients with hypertensive cerebral hemorrhage,half the amount of mannitol treatment can reduce neurological damage,less damage to the kidney.

关 键 词：高血压 脑出血 甘露醇 剂量 肾功能 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]