甘露醇对急性颅内高压危重患儿脑血流的影响

目的：探讨甘露醇对急性颅内高压征危重患儿脑血流动力学的影响。方法：采用经颅多普勒（ TCD）监测25例急性颅内高压征危重患儿，使用甘露醇前、后大脑中动脉频谱形态和血流速度变化。结果：23例急性颅内高压患儿注射甘露醇0.5 h后收缩期峰流速（ Vp）、舒张期末血流速度（ Vd）、平均血流速度（ Vm）均增加，搏动指数（PI）降低（P﹤0.05），20例TCD频谱改变呈高阻力型，2例注射甘露醇前后均无脑血流信号。结论：急性颅内高压患儿使用甘露醇治疗可改善脑血流灌注，但对于TCD频谱变化明显异常、舒张期血流消失或反向血流的患儿甘露醇疗效不佳，预后差。

The efects of mannitol on cerebral blood flow condition of Children with acute intracranial hypertension

Objective：To explore the effect of mannitol on cerebral hemodynamics in patients with acute intracranial hyper-tension syndrome. Methods：25 cases with acute intracranial hypertension were detected by transcranial Doppler（ TCD）. The middle cerebral artery for target vessel,observe the frequency spectrum form and the blood flow velocity changes. Results：23 cases of acute intracranial hypertension injected of mannitol after 0. 5 h,the peak velocity in systolic（ Vp）,the velocity in end diastolic（Vd）,the mean flow velocities（Vm）were increased（P﹤0. 05）,the pulsatility index（PI）decreased（P﹤0. 05 ）,20 cases of TCD spectrum changes showed high resistance type,2 cases had no cerebral blood flow signal before and after treatment with mannitol. Conclusions：Using mannitol therapy for patients with acute intracranial hypertension can improve cerebral blood flow perfusion,but the patients with TCD spectrum changed obviously abnormal, flow away in Diastolic,The reverse flow were Poor prognosis.