评价地塞米松和甘露醇合用对急性重症脑血管病脑保护作用疗效.docVIP

评价地塞米松和甘露醇合用对急性重症脑血管病脑保护作用疗效 　　[摘要] 目的 分析探讨地塞米松和甘露醇合用对急性重症脑血管病脑保护作用的疗效。方法 整群选取该院2011年8月―2013年8月收治的急性重症脑血管病患者88例，随机分为对照组和观察组，对照组患者采用甘露醇治疗，观察组患者采用地塞米松联合甘露醇治疗。比较两组患者的颅内压（ICP），并发症和格拉斯哥昏迷（GCS）评分。 结果 观察组患者不同时间段ICP恢复正常例数所占比率与对照组比较差异有统计学意义，P0.05；治疗后第3个月，观察组患者的GCS评分明显优于对照组，P0.05，具有统计学意义。结论 地塞米松与甘露醇合用治疗急性重症脑血管疾病，患者ICP恢复速度快，患者预后情况良好，且不会增加治疗期间的并发症，能够有效降低颅内压、保护脑细胞、减轻脑水肿，值得临床大力推广。 　　[关键词] 地塞米松；甘露醇；重症脑血管；脑保护 　　[中图分类号] R74 [文献标识码] A [文章编号] 1674-0742（2015）04（c）-0115-02 　　[Abstract] Objective To discuss the cerebral protection of dexamethasone combined with mannitol in the treatment of severe cerebrovascular disease. Methods 88 patients with acute severe cerebrovascular who were treated between August 2011 and August 2013 in our hospital were randomly divided into control group and observation group. Patients in the control group patients were treated with mannitol， while that in the observation group were treated by dexamethasone combined with mannitol. Compare two groups of patients with intracranial pressure （ICP）， complications， and Glasgow coma score （GCS）. Results The observation group of patients with different period of ICP cases restored to normal proportion compared with the control group had significant difference， P 0.05； 3 months after treatment， the observation group of patients with GCS score was better than control group， P 0.05， with statistical significance. Conclusion Dexamethasone and mannitol therapy for severe acute cerebrovascular disease， patients with ICP， fast recovery and patients prognosis is good， and do not increase complications during treatment， can effectively reduce the intracranial pressure， protect brain cells， reduce brain edema， is worth promoting in the clinical practice. 　　[Key words] Dexamethasone； Mannitol； Severe cerebrovascular； Cerebral Protection 　　急性脑血管病是目前致残率和致死率极高的疾病，该病是由脑部血管有关的病变引发的神经系统病症。急性脑血管疾病会使患者出现失语、偏瘫和其他精神方面的症状，严重者会导致昏迷或死亡，对患者的生命健康造成极大的威胁[1]。地塞米松和甘露醇都是具有保护脑细胞、降低颅内压、减轻脑水肿等作用的药物，该次研究选取了88例急性重症脑血管患者，采用地塞米松和甘露醇联合进行治疗，观察分析其脑