甘露醇治疗脑出血后脑水肿54例临床剖析.docVIP

甘露醇治疗脑出血后脑水肿54例临床剖析 　　中图分类号：R743.34 文献标识码： A 文章编号： 1814-8824(2008)-9-0017-02 　　摘要:目的 探讨甘露醇对脑出血后脑水肿的影响。方法 对入选的54例脑出血患者进行回顾性分析，将其分为发病24小时内入院应用甘露醇组（35例）和24小时后入院应用甘露醇组（19例）;48小时和2周后复查脑CT，通过对比脑水肿的变化，分析脑出血发病24小时内应用甘露醇对脑水肿的影响。结果 发病24小时内使用甘露醇组48小时出现脑水肿加重者5例（14.3%），2周后21例（60.0%）;24小时后使用甘露醇组48小时出现脑水肿加重者1例（5.3%），2周后3例（15.9%）。两者48小时CT比较差异无显著意义（P0.05），2周后CT比较差异有非常显著意义（P0.01）;2周后疗效比较差异有显著意义（P0.05）。 结论 脑出血患者发病24小时内不适当应用甘露醇可使脑水肿和病情加重。因此，脑出血患者早期使用甘露醇应慎重。 　　关键词 甘露醇 脑出血 脑水肿 　　 　　Clinical Analysis On 54 Cases Of Brain Edema After Intracerebral Hemorrhage Treated With Mannitol.Li Wei， Huang Zhi-mei， Sun Li.The First Mineral Hospital Of Pengdingshan Coal Industry Medical Groups 　　【Abstract】 Objective To investigate the influence of mannitol on brain edema after cerebral hemorrhage.Methods The data of51patients with cerebral hemorrhage were retrospectively analyzed.51patients were randomly divided into two groups，group A（n=35）was treated with mannitol within 24hours，and group B（n=19）was treated with mannitol after 24hours.Cranial CTwas performed in 48hours and 2weeks.The influence of using man-nitol within 24hours after the onset on brain edema was analyzed.Results 5（14.3%）patients in group A had exac-erbation on brain edema in 48 hours and 21（60.0%）patients in 2weeks，however，1（5.3%）patients in group B had exacerbation of brain edema in48hours and3（15.9%）patients in 2 weeks.There was no significant difference in cranial CT in 48 hours between the two groups（P0.05），there was a significant difference in cranial CT after two weeks between two groups（P0.01）.There was a significant difference in the therapeutic effect after two weeks between two groups（P0.05）.Conclusion The improper application of mannitol with in 24 hours after the onset in patients with cerebral hemorrhage may increase the incidence of exacerbation of brain edema and may exacer-bate patients condition.For patients with cerebral hemorrhage within 24 hours after the onset，mannitol should beused prudently in order to pre