甘露醇联合地塞米松对感染性脑水肿患者相关指标的影响  

Effects of Mannitol Combined with Dexamethasone on Related Indexes of Patients with Infectious Brain Edema

作　　者：陆蒂青[1] 张冬云[2] 闪海霞[1] 

机构地区：[1]南阳市中心医院/郑州大学附属南阳医院感染性疾病科,河南南阳473000 [2]南阳医学高等专科学校基础医学部,河南南阳473000

出　　处：《中国药房》2017年第24期3362-3364,共3页China Pharmacy

摘　　要：目的:探讨甘露醇联合地塞米松对感染性脑水肿患者相关指标的影响。方法:回顾性分析120例感染性脑水肿患者资料,按治疗方案的不同分为对照组(60例)和观察组(60例)。对照组患者给予呋塞米注射液20 mg+20%甘露醇注射液1 g/(kg·次)+0.9%氯化钠注射液10 mL,静脉滴注,每6 h 1次,用药3 d后视患者病情调整剂量。观察组患者给予地塞米松磷酸钠注射液10～20 mg+20%甘露醇注射液1 g/(kg·次)+0.9%氯化钠注射液10 mL,静脉滴注,每6 h 1次,用药3 d后视患者病情调整剂量。两组均以7 d为1个疗程,共治疗2个疗程。观察两组患者治疗前后一氧化氮(NO)、白细胞介素1(IL-1)、肿瘤坏死因子α(TNF-α)水平,病死率、后遗症及不良反应发生情况。结果:治疗前,两组患者NO、IL-1、TNF-α水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者NO、IL-1、TNF-α水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者病死率、后遗症及不良反应发生率均显著低于对照组,差异均有统计学意义(P<0.05)。结论:甘露醇联合地塞米松能降低感染性脑水肿患者的炎症因子水平、后遗症发生率及病死率,且未增加不良反应的发生。OBJECTIVE： To investigate the effects of mannitol combined with dexamethasone on related indexes of patients with infectious brain edema. METHODS： A total of 120 patients with infectious cerebral edema were divided into control group （60 cases） and observation group （60 cases） according to therapy plan. Control group was given Furosemide injection 20 mg＋20% Mannitol injection 1 g/（kg-time）＋0.9% Sodium chloride injection 10 mL intravenously, every 6 h, 3 days later adjusting drug dose according to the disease condition of patients. Observation group was given Dexamethasone injection 10-20 mg＋20% Mannitol injection 1 g/（kg.time）＋ 0.9% Sodium chloride injection 10 mL intravenously, every 6 h, 3 days later adjusting drug dose accord- ing to the disease condition of patients. A treatment course lasted for 7 d, and both groups were treated for 2 courses of treatment. The levels of NO, IL-1 and TNF-ct, mortality and the occurrence of sequelae before and after treatment as well as the occurrence of ADR were observed in 2 groups. RESULTS： Before treatment, there was no statistical significance in the levels of NO, IL-1 or TNF-a between 2 groups （P〉0.05）. After treatment, the levels of NO, IL-1 and TNF-a in 2 groups were significantly lower than before treatment, and the observation group was significantly lower than the control group, with statistical significance （P〈0.05）. The incidence of mortality, sequelae and ADR in observation group were significantly lower than control group, with statistical sig- nificance （P〈0.05）. CONCLUSIONS： Mannitol combined with dexamethasone can reduce inflammatory factor level, the inci- dence of sequelae and mortality, without increasing the incidence of ADR.

关 键 词：甘露醇 地塞米松 呋塞米 感染性脑水肿 炎症因子 安全性 

分 类 号：R63[医药卫生—外科学]