托拉塞米治疗急性脑出血后脑水肿疗效分析  

Effect of torasemide on encephaledema after acute cerebral hemorrhage

作　　者：田思思[1] 郭再玉[1] 赵卫华[1] 

机构地区：[1]天津市泰达医院神经科,300457

出　　处：《中国医药》2013年第3期339-341,共3页China Medicine

摘　　要：目的观察托拉塞米治疗急性脑出血后脑水肿的疗效。方法将50例急性脑出血后脑水肿患者完全随机分为观察组和对照组，各25例。在改善脑代谢、控制血压、控制血糖等对症支持治疗基础上，观察组给予托拉塞米20mg和20％甘露醇125ml，2种药物每6小时交替静脉用药；对照组给予呋塞米20mg和20％甘露醇125ml，用法同观察组。然后逐渐延长用药间隔时间。入院后第1—7天通过颅内压监护仪观察颅内压的变化；治疗14d后，观察2组患者神经功能缺损改善情况及监测电解质的变化。结果观察组治疗14d后，神经功能缺损基本痊愈8例（32．0％），显著进步14例（56．O％），进步3例（12．0％）；对照组基本痊愈5例（20．0％），显著进步11例（44．0％），进步8例（32．0％），恶化1例（4．0％）；观察组神经功能缺损改善明显优于对照组，差异有统计学意义（P〈0．05）。观察组治疗第1—7天颅内压明显低于对照组，电解质紊乱发生率明显低于对照组[12．O％（3／25）比40．0％（10／25）]，差异均有统计学意义（P〈0．05或P〈0．01）。治疗后观察组总有效率明显高于对照组[92．0％（23／25）比72．0％（18／25）]，差异有统计学意义（P〈0．05）。结论托拉塞米治疗急性脑出血后脑水肿效果好，且电解质紊乱等并发症发生相对较少。Objective To evaluate the effect of torasemide injection on encephaledema after acute cerebral hemorrhage. Methods A randomized clinical trial was conducted to compare the effect and side effects between observation group（ mannitol and torasemide） and control group（ mannitol and furosemide） in 50 subjects with encephaledema after acute cerebral hemorrhage. Results After treatment for 14 days, 8 cases were cured in neurological function deficit, 14 cases got improved and 3 cases made progress in observation group; 5 cases were cured, 11 cases achieved significant improvement, and 8 cases made progress, 1 case got worse in control group. The improve ment of neurological function deficit in observation group was better than that in control group （ P 〈 0.05 ）. The intracranial pressure and the incidence rate of electrolyte imbalances of observation group was significantly lower than those of control group（P 〈 0.05 or P 〈 0.01 ）. The total effective rate in observation group was higher than that in control group [ 92.0% （23/25） vs 72.0% （ 18/25 ）, P 〈 0.05 ]. Conclusion Torasemide is an effective and safe drug in treatment of encephaledema after acute cerebral hemorrhage.

关 键 词：托拉塞米 甘露醇 脑出血 急性 颅内压 

分 类 号：R742[医药卫生—神经病学与精神病学]