中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
8期
1139-1140
,共2页
脑出血%甘露醇%早期阶段
腦齣血%甘露醇%早期階段
뇌출혈%감로순%조기계단
Cerebral hemorrhage%Mannitol%Early stage
目的 探讨早期应用甘露醇对颅内血肿的影响.方法 回顾178例颅内血肿患者资料,根据治疗方法分为观察组(88例)和对照组(90例),两组患者入院后均行CT检查,给予一般治疗的基础上,观察组出血6h内给予甘露醇静脉滴注,对照组入院后不给予甘露醇.治疗后24 h复查CT,随诊1个月以上.观察两组治疗前后血肿大小变化、GCS评分及1个月后生活质量.结果 出血量观察组(27.6±5.7)ml,对照组(23.1±4.8)ml；观察组血肿增大患者所占比例(72.73％)明显大于对照组(P＜0.05).GCS评分观察组(5.0±1.5)分,对照组(9.5±1.5)分,观察组明显低于对照组(P＜0.05).治疗后1个月病死率观察组15.91％(14/88),对照组7.78％(7/90),两组差异有统计学意义(P＜0.05).中残疾以上患者发生率观察组69.32％ (61/88),对照组40.00(36/90),观察组明显高于对照组(P＜0.05).结论 早期应用甘露醇可增加血肿增大率,明显增加患者病死率及致残率,建议颅内血肿早期患者避免使用甘露醇脱水治疗.
目的 探討早期應用甘露醇對顱內血腫的影響.方法 迴顧178例顱內血腫患者資料,根據治療方法分為觀察組(88例)和對照組(90例),兩組患者入院後均行CT檢查,給予一般治療的基礎上,觀察組齣血6h內給予甘露醇靜脈滴註,對照組入院後不給予甘露醇.治療後24 h複查CT,隨診1箇月以上.觀察兩組治療前後血腫大小變化、GCS評分及1箇月後生活質量.結果 齣血量觀察組(27.6±5.7)ml,對照組(23.1±4.8)ml；觀察組血腫增大患者所佔比例(72.73％)明顯大于對照組(P＜0.05).GCS評分觀察組(5.0±1.5)分,對照組(9.5±1.5)分,觀察組明顯低于對照組(P＜0.05).治療後1箇月病死率觀察組15.91％(14/88),對照組7.78％(7/90),兩組差異有統計學意義(P＜0.05).中殘疾以上患者髮生率觀察組69.32％ (61/88),對照組40.00(36/90),觀察組明顯高于對照組(P＜0.05).結論 早期應用甘露醇可增加血腫增大率,明顯增加患者病死率及緻殘率,建議顱內血腫早期患者避免使用甘露醇脫水治療.
목적 탐토조기응용감로순대로내혈종적영향.방법 회고178례로내혈종환자자료,근거치료방법분위관찰조(88례)화대조조(90례),량조환자입원후균행CT검사,급여일반치료적기출상,관찰조출혈6h내급여감로순정맥적주,대조조입원후불급여감로순.치료후24 h복사CT,수진1개월이상.관찰량조치료전후혈종대소변화、GCS평분급1개월후생활질량.결과 출혈량관찰조(27.6±5.7)ml,대조조(23.1±4.8)ml；관찰조혈종증대환자소점비례(72.73％)명현대우대조조(P＜0.05).GCS평분관찰조(5.0±1.5)분,대조조(9.5±1.5)분,관찰조명현저우대조조(P＜0.05).치료후1개월병사솔관찰조15.91％(14/88),대조조7.78％(7/90),량조차이유통계학의의(P＜0.05).중잔질이상환자발생솔관찰조69.32％ (61/88),대조조40.00(36/90),관찰조명현고우대조조(P＜0.05).결론 조기응용감로순가증가혈종증대솔,명현증가환자병사솔급치잔솔,건의로내혈종조기환자피면사용감로순탈수치료.
Objective To study the influence of mannitol used in eraly stage of intracranial hematoma.Methods 178 cases diagnosed intracranial hematoma were divided into two groups according to the treatment.After admission,all patients were detected by CT.On the basis of the routine treatment,the treatment group(88 cases) were given mannitol within 6h after bleeding,while the control group were given nothing.To observe the change in hematoma size,GCS score and the quality of life 30d after treatment.Results The experiment group's average bleeding loss was(27.6±5.7)ml,while the control group's average bleeding loss was(23.1 ±4.8)ml,the proportion of patient of treatment groups whose hematoma increased was significantly greater than the control group(P ＜0.05).At the aspect of GCS score,the experiment group was (5.0 ± 1.5 ),while the control group was ( 9.5 ± 1.5 ),the average score of treatment group was significantly lower than the control group(P ＜ 0.05).30d after treatment,14 cases of experiment group dead,the mortality rate was 15.91％,while the control group's motality rate was 7.78％.The mortality rate of treatment group was significantly higher than the control group(P ＜ 0.05).Conclusion Mannitol used in early stage of intracranial hematoma promotes the growth of intracranial hematoma and increases the mortality.The patients with intracranial hematoma should avoid the use of manntol in early stage.
