中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
23期
7-9
,共3页
颅内出血%高血压性%甘露醇%血液动力学现象
顱內齣血%高血壓性%甘露醇%血液動力學現象
로내출혈%고혈압성%감로순%혈액동역학현상
Intracranial hemorrhage,hypertensive%Mannitol%Hemodynamic phenomena
目的 观察不同剂量甘露醇对高血压性脑出血(HIH)患者脑血流动力学的影响.方法 将60例HIH患者按照随机数字表法分为三组,每组20例.在脑出血常规治疗的同时A组给予20%甘露醇250ml,3～4次/d,连续使用14～21 d;B组给予20%甘露醇125ml,根据病情决定每天给予次数和治疗时间;C组不使用甘露醇.采用经颅多普勒超声仪检测出血侧大脑中动脉M1段的平均血流速度(Vm)和搏动指数(PI),并监测所有患者的肾功能变化.结果 三组治疗后1 d的Vm比较差异无统计学意义(P＞0.05),而治疗后10 d、3周A组和B组Vm分别为(45.01±5.13)、(59.41±7.24)cm/s和(44.61±5.04)、(58.94±7.12)cm/s,均显著高于C组的(42.42±4.26)、(55.06±7.16)cm/s(P＜0.05),但A组和B组比较差异无统计学意义(P＞0.05).PI随治疗时间的延长而逐渐恢复,但治疗后1 d、10d及3周三组PI比较差异均无统计学意义(P＞0.05).治疗后3周,A组肾功能异常率[35.0%(7/20)]显著高于B组[20.0%(4/20)]和C组[15.0%(3/20)](P＜0.05).结论 应用小剂量甘露醇治疗HIH,不仅可以增加脑血流速度,改善脑血流灌注,减轻脑缺血性损伤,而且肾功能损伤小,安全性较高.
目的 觀察不同劑量甘露醇對高血壓性腦齣血(HIH)患者腦血流動力學的影響.方法 將60例HIH患者按照隨機數字錶法分為三組,每組20例.在腦齣血常規治療的同時A組給予20%甘露醇250ml,3～4次/d,連續使用14～21 d;B組給予20%甘露醇125ml,根據病情決定每天給予次數和治療時間;C組不使用甘露醇.採用經顱多普勒超聲儀檢測齣血側大腦中動脈M1段的平均血流速度(Vm)和搏動指數(PI),併鑑測所有患者的腎功能變化.結果 三組治療後1 d的Vm比較差異無統計學意義(P＞0.05),而治療後10 d、3週A組和B組Vm分彆為(45.01±5.13)、(59.41±7.24)cm/s和(44.61±5.04)、(58.94±7.12)cm/s,均顯著高于C組的(42.42±4.26)、(55.06±7.16)cm/s(P＜0.05),但A組和B組比較差異無統計學意義(P＞0.05).PI隨治療時間的延長而逐漸恢複,但治療後1 d、10d及3週三組PI比較差異均無統計學意義(P＞0.05).治療後3週,A組腎功能異常率[35.0%(7/20)]顯著高于B組[20.0%(4/20)]和C組[15.0%(3/20)](P＜0.05).結論 應用小劑量甘露醇治療HIH,不僅可以增加腦血流速度,改善腦血流灌註,減輕腦缺血性損傷,而且腎功能損傷小,安全性較高.
목적 관찰불동제량감로순대고혈압성뇌출혈(HIH)환자뇌혈류동역학적영향.방법 장60례HIH환자안조수궤수자표법분위삼조,매조20례.재뇌출혈상규치료적동시A조급여20%감로순250ml,3～4차/d,련속사용14～21 d;B조급여20%감로순125ml,근거병정결정매천급여차수화치료시간;C조불사용감로순.채용경로다보륵초성의검측출혈측대뇌중동맥M1단적평균혈류속도(Vm)화박동지수(PI),병감측소유환자적신공능변화.결과 삼조치료후1 d적Vm비교차이무통계학의의(P＞0.05),이치료후10 d、3주A조화B조Vm분별위(45.01±5.13)、(59.41±7.24)cm/s화(44.61±5.04)、(58.94±7.12)cm/s,균현저고우C조적(42.42±4.26)、(55.06±7.16)cm/s(P＜0.05),단A조화B조비교차이무통계학의의(P＞0.05).PI수치료시간적연장이축점회복,단치료후1 d、10d급3주삼조PI비교차이균무통계학의의(P＞0.05).치료후3주,A조신공능이상솔[35.0%(7/20)]현저고우B조[20.0%(4/20)]화C조[15.0%(3/20)](P＜0.05).결론 응용소제량감로순치료HIH,불부가이증가뇌혈류속도,개선뇌혈류관주,감경뇌결혈성손상,이차신공능손상소,안전성교고.
Objective To observe the influence of different dosage of mannitol on hemodynamics after hypertensive intracerebral hemorrhage ( HIH ). Methods Sixty cases with HIH were divided into three groups by random digits table with 20 cases each. Performing routine treatment, also 20% mannitol 250 ml was used 3-4 times/d for 14-21 d in group A,20% mannitol 125 ml was used 2-3 times/d for 3-14 d in group B,and mannitol was not used in group C. The mean blood flow velocity(Vm) and pulsatility index (PI)in bleeding side of the middle cerebral artery (M1) were measured by TCD, and monitoring patient's kidney function. Results After treatment 1 d , Vm comparative differences among three groups were no statistically significant (P ＞ 0.05 ), and after treatment 10 d and 3 weeks, the Vm in group A [(45.01 ± 5.13 ), (59.41 ±7.24) cm/s] and group B [(44.61 ± 5.04), (58.94 ±7.12) cm/s] were significantly higher than those in group C [(42.42 ±4.26), (55.06 ±7.16) cm/s] (P ＜0.05), but the differences were no statistically significant between group A and group B (P ＞0.05). With the extension of treatment time, PI recovery gradually, but compared PI,after treatment 1 d, 10 d and 3 weeks,there were no statistical differences among three groups (P ＞ 0.05 ). After treatment 3 weeks, kidney function abnormal ratio in group A [35.0%(7/20)] was significantly higher than that in group B [20.0% (4/20)] and group C [15.0% (3/20)] (P＜0.05). Conclusion Using small dosage of mannitol,not only increase HIH cerebral blood flow velocity,improve brain blood perfusion,reduce cerebral ischemic injury,but also reduce kidney damage,safety is higher.
