急性期使用甘露醇对高血压脑出血患者的影响  

Effect of mannitol used during acute phase on the patients with hypertensive cerebral hemorrhage

作　　者：陈谦学[1] 李侠[1] 秦军[2] 李名桥[2] 

机构地区：[1]武汉大学人民医院神经外科,武汉430060 [2]湖北医药学院附属太和医院神经外科二病区,十堰442000

出　　处：《中国临床神经外科杂志》2012年第12期741-742,共2页Chinese Journal of Clinical Neurosurgery

摘　　要：目的观察急性期应用甘露醇对高血压脑出血的患者的影响。方法选取高血压脑出血急性期患者150例,分为三组,即大剂量甘露醇治疗组、小剂量甘露醇治疗组和对照组。两治疗组入院后12h内分别给予250ml和125ml15%的甘露醇静脉快速输注,对照组除不输甘露醇外,余处理同治疗组。三组患者入院即行急诊头颅CT检查,发病24h后复查头颅CT,观察血肿是否扩大。结果入院时三组患者脑内血肿的量无显著差异(P>0.05)。入院后24h,大剂量甘露醇治疗组、小剂量甘露醇治疗和对照组血肿量分别为(19.69±9.13)ml、(15.38±7.89)ml和(15.60±7.63)ml,大剂量甘露醇治疗组的血肿量明显大于其余两组(P<0.05)。结论脑出血急性期大剂量使用甘露醇可引起血肿扩大,小剂量使用或不使用甘露醇对血肿大小无明显影响。Objective To explore the effect of mannitol used during the acute phase on the patients with hypertensive cerebral hemorrhage （HCH）. Methods One hundred and fifty patients with HCH were randomly divided into three groups of 50 patients each, i.e. groups A [rapid intravenous infusion of large dose （250 ml, ter in die） 15% mannitol], B [rapid intravenous infusion of small dose （125 ml, ter in die） 15% mannitol] and C （no infusion of mannitol）. The change hematomas volumes shown by CT were analyzed and compared among the three groups 24 hours after HCH. Results The hematomas volumes in groups A, B and C were （19.69~9.13）ml, （15.38~7.89） ml and （15.60~7.63）ml respectiely 24 hours after HCH. The hematomas volumes was significant bigger in group A than those in groups B and C 24 hours after HCH （P〈0.05）, when there was insignificant difference in the hematomas volumes between groups B and C （P〉 0.05）. Conclusion The intravenous infusion of large dose manitol during the acute phase should be cautious because it may produce the intracerebral rebleeding in the patients with HCH.

关 键 词：甘露醇 高血压脑出血 急性期 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]