甘露醇对缺血性脑水肿患者肾功能的影响  

Analysis of the Effect of Mannitol in Preventing Ischemic Brain Edema on Renal Function

作　　者：侯华 宋丽 HOU Hua;SONG Li(Department of Neurology,Zhongyi Northeast International Hospital,Shenyang 111000,Liaoning,China;Department of Neurology,Liaoyang Central Hospital,Shenyang 111000,Liaoning,China)

机构地区：[1]中一东北国际医院神经内科,辽宁辽阳111000 [2]辽阳市中心医院神经内科,辽宁辽阳111000

出　　处：《中国药物滥用防治杂志》2021年第6期981-983,996,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨甘露醇对缺血性脑水肿患者肾功能的影响。方法:连续入选2019年1月—2021年3月在该院治疗的150例缺血性脑水肿患者,按照甘露醇剂量的不同分为研究组和对照组,各75例。对照组采用20%甘露醇250 ml治疗,研究组采用20%甘露醇125 ml治疗,比较两组治疗前后水肿体积、颅内压、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分(GCS)和急性肾功能衰竭发生情况。结果:两组治疗后水肿体积、颅内压、NIHSS、GCS评分较治疗前改善,但组间比较,差异无统计学意义(P>0.05)。研究组治疗第5、10天急性肾功能衰竭发生率低于对照组,差异有统计学意义(P<0.05)。结论:250 ml与125 ml 20%甘露醇治疗缺血性脑水肿的临床疗效相当,但125 ml 20%甘露醇对肾功能的损伤小,安全性更高。Objective:To explore the effect of mannitol on renal function in patients with ischemic cerebral edema.Methods:The 150 patients with ischemic brain edema who were continuously selected for treatment in the hospital from January 2019 to March 2021 were divided into a study group and a control group according to the different doses of mannitol,with 75 cases in each group.The control group was treated with 20%mannitol 250 ml,and the study group was treated with 20%mannitol 125 ml.The volume of edema,intracranial pressure,and the National Institute of Health Stroke Scale(NIHSS),Glasgow coma scale(GCS)and the occurrence of acute renal failurewere compared between the two groups before and after treatment.Results:After treatment,the edema volume,intracranial pressure,NIHSS,and GCS scores of the two groups improved compared with those before treatment,but there was no statistically significant difference between the groups(P>0.05).The incidence of acute renal failure on the 5 th and 10 th day of treatment in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:TThe clinical efficacy of 250 ml 20%mannitol is equivalent to that of 125 ml 20%mannitol in the treatment of ischemic brain edema.125 ml 20%mannitol has less damage to renal function and is safer.

关 键 词：甘露醇 缺血性脑水肿 肾功能 颅内压 尿常规 

分 类 号：R742[医药卫生—神经病学与精神病学] R692.5[医药卫生—临床医学]