中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2009年
3期
228-230,239
,共4页
高渗盐水%甘露醇%脑水肿%颅内压
高滲鹽水%甘露醇%腦水腫%顱內壓
고삼염수%감로순%뇌수종%로내압
Hypertonic saline%Mannitol%Brain edema%Intracranial pressure
目的 比较3%高渗盐水和20%甘露醇治疗小儿急性脑水肿的疗效.方法 将20例急性脑水肿患儿随机分为高渗盐水组和甘露醇组(每组各10例),接受3%高渗盐水或20%甘露醇治疗.用药前及用药后30 min,1、2、3、4、5、6 h,观察颅内压(ICP)、平均动脉压(MAP)、中心静脉压(CVP)、脑灌注压(CPP)、血电解质、血浆渗透压、肾功能以及尿量的变化.结果 3%高渗盐水和20%甘露醇均可显著降低ICP(P＜0.05).3%高渗盐水有效降ICP时间持续(4.5±1.2)h,20%甘露醇有效降ICP时间持续(3.2±1.5)h,差异有显著性(P＜0.05).且在用药2 h后,高渗盐水组MAP和CPP明显高于甘露醇组(P＜0.05).结论 3%高渗盐水与20%甘露醇均可迅速降低ICP,但3%高渗盐水作用持续时间比20%甘露醇更长,且可更好地稳定循环和提高脑血流灌注.
目的 比較3%高滲鹽水和20%甘露醇治療小兒急性腦水腫的療效.方法 將20例急性腦水腫患兒隨機分為高滲鹽水組和甘露醇組(每組各10例),接受3%高滲鹽水或20%甘露醇治療.用藥前及用藥後30 min,1、2、3、4、5、6 h,觀察顱內壓(ICP)、平均動脈壓(MAP)、中心靜脈壓(CVP)、腦灌註壓(CPP)、血電解質、血漿滲透壓、腎功能以及尿量的變化.結果 3%高滲鹽水和20%甘露醇均可顯著降低ICP(P＜0.05).3%高滲鹽水有效降ICP時間持續(4.5±1.2)h,20%甘露醇有效降ICP時間持續(3.2±1.5)h,差異有顯著性(P＜0.05).且在用藥2 h後,高滲鹽水組MAP和CPP明顯高于甘露醇組(P＜0.05).結論 3%高滲鹽水與20%甘露醇均可迅速降低ICP,但3%高滲鹽水作用持續時間比20%甘露醇更長,且可更好地穩定循環和提高腦血流灌註.
목적 비교3%고삼염수화20%감로순치료소인급성뇌수종적료효.방법 장20례급성뇌수종환인수궤분위고삼염수조화감로순조(매조각10례),접수3%고삼염수혹20%감로순치료.용약전급용약후30 min,1、2、3、4、5、6 h,관찰로내압(ICP)、평균동맥압(MAP)、중심정맥압(CVP)、뇌관주압(CPP)、혈전해질、혈장삼투압、신공능이급뇨량적변화.결과 3%고삼염수화20%감로순균가현저강저ICP(P＜0.05).3%고삼염수유효강ICP시간지속(4.5±1.2)h,20%감로순유효강ICP시간지속(3.2±1.5)h,차이유현저성(P＜0.05).차재용약2 h후,고삼염수조MAP화CPP명현고우감로순조(P＜0.05).결론 3%고삼염수여20%감로순균가신속강저ICP,단3%고삼염수작용지속시간비20%감로순경장,차가경호지은정순배화제고뇌혈류관주.
Objective To compare the clinical efficacy of 3% hypertonic saline with 20% mannitol in the treatment of acute brain edema in children.Methods Twenty children with acute brain edema were randomly divided into hypertonic saline(HS) group and mannitol group.HS group and mannitol group were given 3% HS solution or 20% mannitol respectively.Main outcome measurements included intracranial pressure(ICP),mean arterial pressure(MAP),central venous pressure(CVP),cerebral perfusion pressure (CPP),serum electrolytes,plasma osmolality,renal function and urine volume.Results Both 3% HS and 20% mannitol were effective in reducing ICP(P ＜0.05).Therapeutic effect lasted(4.5±1.2) h in HS group and(3.2±1.5) h in mannitoi group.3% HS had a longer duration of action than marmitol(P＜0.05).At the time point of 2 hours after treatment,MAP and CPP of HS group increased more than those of mannitol group(P＜0.05).Conclusion Both 3% HS and 20% mannitol could rapidly decrease ICP.3% HS has a longer duration of action in reducing ICP than 20% mannitol.3% HS is more effective in stabilizing circulation and improving CPP than 20% mannitol.
