高血压脑出血早期应用甘露醇治疗的临床分析

目的:探讨高血压脑出血早期应用甘露醇治疗的临床疗效和不良反应。方法:将我院收治高血压脑出血患者64例随机分为三组,A组20例,24h内给予甘露醇常规剂量250mL静脉点滴治疗,1次/(8-12)h;B组21例,患者24h内给予甘露醇半量125mL静脉点滴治疗,1次/(8-12)h;C组23例,发病后24h内未接受甘露醇治疗;三组其他治疗无差别。观察三组患者降颅压效果,神经系统功能缺损评分情况及血肌酐、血尿素氮变化。结果:A、B组患者降颅压疗效显著优于C组(P<0.01),B、C患者神经功能缺损评分低于A组(P<0.05),B、C两组患者神经功能缺损评分无显著差异(P>0.05)。治疗7d后A、B两组BUN、Cr明显升高,与治疗前相比有统计学差异(P<0.05),C组BUN、Cr值与治疗前无统计学差异(P>0.05),但B组患者BUN、Cr值低于A组(P<0.05)。结论:高血压脑出血早期应用甘露醇治疗可以有效降低患者颅内高压,半量甘露醇治疗可以减轻神经功能损害,对肾功能损伤较轻,是治疗高血压脑出血的合适剂量。

The Clinical Analysis of Mannitol Therapy for Early Stage of Patients with Hypertensive Cerebral Hemorrhage

Objective: To investigate the efficacy and adverse reactions of mannitol treatment of hypertensive cerebral hemorrhage.Method: 64 patients of hypertensive cerebral hemorrhage were randomly divided into three groups,A group,20 patients,were given regular doses of intravenous mannitol treatment,24h in 250mL;B group,21 patients,were given intravenous mannitol treatment half the amount of 125mL;C group,23 patients,were not receive mannitol;other treatment no difference.Observing the intracranial pressure lowering,neurological deficit scores and BUN,Cr changes.Result: The intracranial pressure effect of A,B group was significantly better than group C(P <0.01),the neurological deficit score of B,C group were lower than group A(P <0.05),B,C reducing the intracranial pressure in patients with treatment groups and neurological deficit score was no significant difference(P> 0.05).After treatment BUN,Cr of A,B group was significantly higher compared with before treatment were significantly different(P <0.05),C group BUN,Cr values before treatment with no significant difference(P> 0.05),but group B patients with BUN,Cr is lower than that of group A(P <0.05).Conclusion: Mannitol treatment can effectively reduce intracranial pressure in patients with hypertensive cerebral hemorrhage,half the amount of mannitol treatment can reduce neurological damage,less damage to the kidney.