甘露醇不同静脉滴注速度对急性脑出血患者治疗效果的影响  

Effect of Different Intravenous Drip Rates of Mannitol on the Efficacy in Treatment of Acute Cerebral Hemorrhage

作　　者：朱琳琳 潘雷灵 鲁静琦 ZHU Linlin;PAN Leiling;LU Jingqi(Dept.of Emergency,Yingtan City People’s Hospital,Jiangxi Yingtan 335000,China)

机构地区：[1]鹰潭市人民医院急诊科,江西鹰潭335000

出　　处：《中国医院用药评价与分析》2019年第3期322-324,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨甘露醇不同静脉滴注速度对急性脑出血患者治疗效果的影响。方法:选取2016年1月至2018年5月鹰潭市人民医院收治的急性脑出血患者120例,以随机抽签法分为A、B组,每组60例。两组患者均给予20%甘露醇治疗,但A组患者以先慢后快的速度滴注(先以5 ml/min的速度滴注5～10 min,再以10 ml/min的速度滴注),B组患者以先快后慢的速度滴注(先以10 ml/min的速度滴注10 min,再以5 ml/min的速度滴注)。比较两组患者的临床疗效、美国国立卫生院卒中神经功能缺损评分量表(national institutes of health stroke scale,NIHSS)评分、颅内压及不良反应发生情况的差异。结果:A、B组患者的总有效率分别为93.33%(56/60)、96.67%(58/60),差异无统计学意义(P>0.05);两组患者治疗前后NIHSS评分的差异均无统计学意义(P>0.05);两组患者治疗前、治疗结束后1 h颅内压的差异均无统计学意义(P>0.05);B组患者电解质紊乱、肾损伤、颅内压反跳及头痛的发生率明显高于A组,差异均有统计学意义(P<0.05)。结论:甘露醇不同静脉滴注速度用于急性脑出血患者的效果相当,但以先慢后快的速度滴注能够有效减少不良反应的发生,避免颅内压一过性升高,更有利于促进患者康复。OBJECTIVE: To probe into the effects of different intravenous drip rates of mannitol on the efficacy in treatment of acute cerebral hemorrhage. METHODS: 120 patients with acute cerebral hemorrhage admitted into Yingtan City People’s Hospital from Jan. 2016 to May 2018 were selected and divided into group A and group B via random lottery, with 60 cases in each group. Both groups were given 20% mannitol, group A was given intravenous drip slowly first and then faster(5 ml/min for 5-10 min, then drip at 10 ml/min), group B was given intravenous drip fast first and then slower(10 ml/min for 10 min, then drip at 5 ml/min). Differences in clinical efficacy, scores of National Institutes of Health Stroke Scale(NIHSS), intracranial pressure and incidences of adverse drug reactions between two groups were compared. RESULTS: The total effective rates of group A and group B were respectively 93.33%(56/60) and 96.67%(58/60), the difference had no statistical significance(P>0.05);there were no statistical significance in differences in NIHSS scores between two groups before and after treatment(P>0.05);there were no statistical significance in difference in intracranial pressure in 1 h between two groups before and after treatment(P>0.05);the incidences of electrolyte disturbance, renal damage, intracranial pressure rebound and headache of group B were significantly higher than those of group A, with statistically significant differences(P<0.05). CONCLUSIONS: The efficacy of different intravenous drip rates of mannitol in treatment of acute cerebral hemorrhage are equivalent, while in the drip rate of fast first and then slower can effectively reduce the occurrence of adverse drug reactions, avoid transient ascending intracranial pressure, and is more conducive to the recovery of patients.

关 键 词：甘露醇 静脉滴注速度 急性脑出血 治疗效果 不良反应 

分 类 号：R972[医药卫生—药品]