甘露醇葡萄糖注射液对心肺复苏术后并发急性颅内高压危重休克患者血流动力学及预后的影响  

Effect of mannitol and glucose injection on hemodynamics and prognosis in patients with acute intracranial hypertension complicated with shock after cardiopulmonary resuscitation

作　　者：王华杰[1] 谢晓红[1] 苏醒[2] 麦叶[1] 

机构地区：[1]海南省人民医院重症医学科,海口市570311 [2]海口市人民医院重症医学科,海口市570301

出　　处：《广西医学》2016年第8期1111-1114,共4页Guangxi Medical Journal

摘　　要：目的 探讨甘露醇葡萄糖注射液对心肺复苏术后并发急性颅内高压危重休克患者血流动力学及预后的影响。方法 选取心肺复苏术后并发急性颅内高压危重休克患者60例，按随机数字表法分为观察组和对照组，每组30例。对照组采用常规救治方法，观察组在常规救治方法基础上给予甘露醇葡萄糖注射液。检测用药前（T0）、用药1 h后（T1）、用药2 h后（T2）和用药4 h后（T3）患者大脑中动脉收缩峰值血流速度（Vp）、舒张期末血流速度（Vd）、平均血流速度（Vm）以及搏动指数（PI），对比两组治疗转归。结果 两组的Vp、Vd、Vm及PI比较，差异均有统计学意义（P＜0.05），T1-3时刻观察组Vp、Vd、Vm均高于对照组，PI低于对照组；随观察时间延长，两组Vp、Vd、Vm均升高，PI降低（P＜0.05）。观察组6～24 h内清醒者及治愈者比例高于对照组（P＜0.05），而并发多器官功能障碍综合征、存在后遗症及死亡者比例低于对照组（P＜0.05）。结论 对心肺复苏术后并发急性颅内高压危重休克患者采用甘露醇葡萄糖注射液治疗可以改善血流动力学指标和转归情况。Objective To explore the effect of mannitol and glucose injection on hemodynamics and prognosis in patients with acute intracranial hypertension complicated with shock after cardiopulmonary resuscitation. Methods Sixty patients with acute intracranial hypertension complicated with shock after cardiopulmonary resuscitation were selected, and were divided into observation group and control group according to the random number table, with 30 cases in each group. The control group was treated with conventional therapy, and the observation group was treated with mannitol and glucose injection on the basis of conventional therapy. The outcome was compared between two groups. Before treatment （ T0 ）, at 1 （ T1 ） ,2 （ T2 ） and 4 hours （ T3 ） after treatment, peak systolic blood flow velocity （ V p ）, end diastolic blood flow velocity（ Vd ）, mean blood flow velocity （Vm ） and pulsatility index（PI） of middle cerebral artery were measured. Results The proportion of awakening patients or patients with recovery in the observation group was higher than that in the control group （ P 〈 0.05 ）. And the proportion of patients with multiple organs dysfunction syndrome, sequelae or death in the observation group was lower than that in the control group（ P 〈 0.05 ）. There were significant differences in Vp, Vd, Vm and PI between two groups （P 〈 0.05 ）. At T1-3, Vp, Vd, and Vm was higher and PI was lower in the observation group compared to the control group. Vp ,Vd ,and Vm increased but PI decreased with the increase of observation time （P 〈 0.05 ）. Conclusion For patients with acute intracranial hypertension complicated with shock after cardiopulmonary resuscitation, mannitol and glucose injection can effectively reduce the degree of cerebral edema, and improve the prognosis and hemodynamic parameters.

关 键 词：急性颅内高压 休克 心肺复苏 甘露醇 葡萄糖注射液 血流动力学 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]