甘露醇治疗围产期缺氧缺血性脑损伤的随机对照研究  

THE RANDOMIZED CONTROLLED TRIAL OF MANNITOL THERAPY IN HYPOXIC-ISCHEMIC BRAIN DAMAGE IN NEWBORN PIGLETS.

作　　者：郭茜[1] 李炜如[1] 姚裕家[1] 周密[1] 

机构地区：[1]华西医科大学附属第二医院儿科,610000

出　　处：《新生儿科杂志》2001年第2期66-68,共3页The Journal of Neonatology

摘　　要：为探讨不同剂量甘露醇减轻脑水肿程度及对神经病理影响 ,将 40只新生猪随机分为正常对照组、缺氧缺血性脑损伤模型组 (HIBD组 )、小剂量 ( 0 5g kg)和大剂量 ( 2g kg)治疗组。四组均测颅内压 (ICP)、脑含水量 (BTWC)、血浆渗透压及病理检查。结果HIBD组BTWC及ICP较正常组明显增高 (P <0 .0 1 )。两治疗组各时相点ICP及BTWC明显低于HIBD组 ,且两治疗组ICP及BTWC下降程度无显著性差异 (P>0 .0 5 ) ,但大剂量组血浆渗透压较小剂量组明显增高 ,峰值达高渗状态 (P <0 0 1 )。表明甘露醇能减轻脑水肿 ,但对神经细胞不可逆改变无治疗作用。小剂量安全有效 ,用药时间 3～ 4小时为宜。Inorder to study the efficacy of mannitol in reducing cerebral edema and improving the neuropathologic outcome in perinatal cerebral hypoxia ischemial. Forty newborn piglets were divided into four groups: normal group, hypoxcic ischemic brain damage (HIBD) model group, low dose mannitol treatment group (0.5·kg -1 ) and high dose mannitol treatment group (2g·kg -1 ).Effects on intracranial pressure (ICP) reduction and changes of serum osmolality and electrolyte were observed. After 6 hours of recovery from hypoxia ischemia, the animals were killed and their brains were examined for brain tissue content (BTWC) and the paathologic alteration.s Results ICP and BTWC in HIBD model group were significantly higher than that in mormal group (P<0.05). Mannitol theraphy reduced ICP and BTWC was not proportionate to the mannitol dose administered. Serum osmolality significantly increased and the dose rseponse characteristics of mannitol usage were presented following the two doses of mannitol administration. mannitol therapy reduces cerebral edema and the low dose of mannitol is safer than high dose in the treatment of HIBD, and it is appropriate to repeat use at 3～4hours intervals.

关 键 词：甘露醇 脑水肿 颅内压 新生儿缺氧缺血性脑病 治疗 

分 类 号：R722.121[医药卫生—儿科]