脑内出血患者使用甘露醇前后血糖及肾功能变化的临床观察.docVIP

脑内出血患者使用甘露醇前后血糖及肾功能变化的临床观察 　　[摘要] 目的 研究脑内出血患者使用甘露醇前后血糖及肾功能变化，探讨其原因和更为安全有效的使用方法。 方法 选取60例保守治疗脑内出血患者，由于血糖基数不同，分为伴糖尿病组和无糖尿组，每组30例，观察静脉滴注每日总量为500、750、1000 ml三种不同剂量甘露醇前后，以血糖浓度、血浆肌酐及尿素氮三项指标，判定甘露醇对血糖及肾功能的影响。 结果 甘露醇使用后患者血糖、血浆尿素氮、血浆肌酐三项指标，随着甘露醇用量的增加而升高，差异有统计学意义（P750 ml，无论是否患有糖尿病，差异有统计学意义（P0.05）。 结论 静脉滴注甘露醇可影响血糖及肾功能；临床对脑内出血患者静脉滴注甘露醇，尤其患者伴有糖尿病时应监测血糖，及时调整用量。 　　[关键词] 脑内出血；保守治疗；糖尿病；甘露醇；血糖及肾功能 　　[中图分类号] R743.34 [文献标识码] A [文章编号] 1674-4721（2014）08（b）-0081-04 　　[Abstract] Objective To study the change of blood sugar and renal function in patients with cerebral hemorrhage after an intravenous drip of mannitol，to discuss the reason for the change and work out much safer and more effective methods of application. Methods Sixty cases of patients with cerebral hemorrhage who received conservative treatment were selected and divided into diabetes group and without diabetes group according to their different blood sugar base，each group of 30 cases.Three indexes of blood sugar concentration，serum creatinine and urea nitrogen was observed in each group of patients before and after given intravenous drip of three different doses of mannitol daily（500，750，1000 ml） respectively.Based on the data，impacts of mannitol on blood sugar and renal function were determined. Results Three indexes kept rising after given intravenous drip of mannitol，the more the dose was，the higher the indexes became，with statistical difference（P0.05）.The increase in the three indexes among patients with diabetes was more obvious compared with the patients without diabetes.When daily dose of 20% mannitol reached 750 ml and above，there was statistical difference among the patients whether sufferred from diabetes or not（P0.05）. Conclusion The study suggests that an intravenous drip of mannitol can impact blood sugar and renal function.In clinical practice，blood sugar should be monitored when giving intravenous drip of mannitol to patients with cerebral hemorrhage，especially who are accompanied with diabetes.And doses