甘露醇的使用（Use of mannitol）.doc

甘露醇的使用（Use of mannitol） Clinical application of mannitol In the acute stage of severe cerebral infarction and cerebral hemorrhage, brain edema caused by ischemia or hemorrhage causes a rapid increase of intracranial pressure and endangers the life of the patient at any moment. Therefore, the treatment of intracranial pressure is particularly important. Because of the lack of detailed clinical guidelines for lowering intracranial pressure, emergency departments or neurologists in primary hospitals sometimes have to choose which drugs to lower their intracranial pressure The question of how to use brain pressure drugs more rationally is confusing. The most commonly used clinical treatment is hypertonic dehydration. It is simple and practical. The aim is to dehydrate the brain tissue and reduce the volume of normal brain tissue. The incubation period from the initial medication to the decrease in intracranial pressure usually takes a few minutes, often at 20~60 minutes, and intracranial pressure drops to a minimum. Decreased intracranial pressure level and duration depends on: (1) the residual volume of normal brain tissue can cause collapse; (2) the proportion of BBB occupied; (3) early before treatment of intracranial pressure; (4) the use of intracranial pressure drug dose and dose rate. Mannitol and glycerin fructose are the most commonly used intracranial pressure lowering drugs in clinic, both of which have advantages and disadvantages. Mannitol is a monosaccharide that is not absorbed in the body and has no metabolic activity. Most of it is excreted from the kidneys and is a permeable diuretic. By increasing the colloid osmotic pressure of plasma, the water in the brain tissue enters into the blood vessel, the volume of the brain tissue is relatively narrow, and the purpose of reducing the intracranial pressure is achieved, and the speed of the intracranial pressure reduction is fast. Rapid intravenous injection of intracranial pressure after 15 minutes, 30~60 m