中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
3期
339-341
,共3页
托拉塞米%甘露醇%脑出血,急性%颅内压
託拉塞米%甘露醇%腦齣血,急性%顱內壓
탁랍새미%감로순%뇌출혈,급성%로내압
Torasemide%Mannitol%Cerebral hemorrhage,acute%Intracranial pressure
目的 观察托拉塞米治疗急性脑出血后脑水肿的疗效.方法 将50例急性脑出血后脑水肿患者完全随机分为观察组和对照组,各25例.在改善脑代谢、控制血压、控制血糖等对症支持治疗基础上,观察组给予托拉塞米20rng和20％甘露醇125 ml,2种药物每6小时交替静脉用药；对照组给予呋塞米20 mg和20％甘露醇125 ml,用法同观察组.然后逐渐延长用药间隔时间.入院后第1～7天通过颅内压监护仪观察颅内压的变化；治疗14 d后,观察2组患者神经功能缺损改善情况及监测电解质的变化.结果 观察组治疗14 d后,神经功能缺损基本痊愈8例(32.0％),显著进步14例(56.0％),进步3例(12.0％)；对照组基本痊愈5例(20.0％),显著进步11例(44.0％),进步8例(32.0％),恶化1例(4.0％)；观察组神经功能缺损改善明显优于对照组,差异有统计学意义(P＜0.05).观察组治疗第1～7天颅内压明显低于对照组,电解质紊乱发生率明显低于对照组[12.0％(3/25)比40.0％(10/25)],差异均有统计学意义(P＜0.05或P＜0.01).治疗后观察组总有效率明显高于对照组[92.0％(23/25)比72.0％(18/25)],差异有统计学意义(P＜0.05).结论 托拉塞米治疗急性脑出血后脑水肿效果好,且电解质紊乱等并发症发生相对较少.
目的 觀察託拉塞米治療急性腦齣血後腦水腫的療效.方法 將50例急性腦齣血後腦水腫患者完全隨機分為觀察組和對照組,各25例.在改善腦代謝、控製血壓、控製血糖等對癥支持治療基礎上,觀察組給予託拉塞米20rng和20％甘露醇125 ml,2種藥物每6小時交替靜脈用藥；對照組給予呋塞米20 mg和20％甘露醇125 ml,用法同觀察組.然後逐漸延長用藥間隔時間.入院後第1～7天通過顱內壓鑑護儀觀察顱內壓的變化；治療14 d後,觀察2組患者神經功能缺損改善情況及鑑測電解質的變化.結果 觀察組治療14 d後,神經功能缺損基本痊愈8例(32.0％),顯著進步14例(56.0％),進步3例(12.0％)；對照組基本痊愈5例(20.0％),顯著進步11例(44.0％),進步8例(32.0％),噁化1例(4.0％)；觀察組神經功能缺損改善明顯優于對照組,差異有統計學意義(P＜0.05).觀察組治療第1～7天顱內壓明顯低于對照組,電解質紊亂髮生率明顯低于對照組[12.0％(3/25)比40.0％(10/25)],差異均有統計學意義(P＜0.05或P＜0.01).治療後觀察組總有效率明顯高于對照組[92.0％(23/25)比72.0％(18/25)],差異有統計學意義(P＜0.05).結論 託拉塞米治療急性腦齣血後腦水腫效果好,且電解質紊亂等併髮癥髮生相對較少.
목적 관찰탁랍새미치료급성뇌출혈후뇌수종적료효.방법 장50례급성뇌출혈후뇌수종환자완전수궤분위관찰조화대조조,각25례.재개선뇌대사、공제혈압、공제혈당등대증지지치료기출상,관찰조급여탁랍새미20rng화20％감로순125 ml,2충약물매6소시교체정맥용약；대조조급여부새미20 mg화20％감로순125 ml,용법동관찰조.연후축점연장용약간격시간.입원후제1～7천통과로내압감호의관찰로내압적변화；치료14 d후,관찰2조환자신경공능결손개선정황급감측전해질적변화.결과 관찰조치료14 d후,신경공능결손기본전유8례(32.0％),현저진보14례(56.0％),진보3례(12.0％)；대조조기본전유5례(20.0％),현저진보11례(44.0％),진보8례(32.0％),악화1례(4.0％)；관찰조신경공능결손개선명현우우대조조,차이유통계학의의(P＜0.05).관찰조치료제1～7천로내압명현저우대조조,전해질문란발생솔명현저우대조조[12.0％(3/25)비40.0％(10/25)],차이균유통계학의의(P＜0.05혹P＜0.01).치료후관찰조총유효솔명현고우대조조[92.0％(23/25)비72.0％(18/25)],차이유통계학의의(P＜0.05).결론 탁랍새미치료급성뇌출혈후뇌수종효과호,차전해질문란등병발증발생상대교소.
Objective To evaluate the effect of torasemide injection on encephaledema after acute cerebral hemorrhage.Methods A randomized clinical trial was conducted to compare the effect and side effects between observation group(mannitol and torasemide) and control group(mannitol and furosemide) in 50 subjects with encephaledema after acute cerebral hemorrhage.Results After treatment for 14 days,8 cases were cured in neurological function deficit,14 cases got improved and 3 cases made progress in observation group; 5 cases were cured,11 cases achieved significant improvement,and 8 cases made progress,1 case got worse in control group.The improvement of neurological function deficit in observation group was better than that in control group (P ＜ 0.05).The intracranial pressure and the incidence rate of electrolyte imbalances of observation group was significantly lower than those of control group(P ＜0.05 or P ＜0.01).The total effective rate in observation group was higher than that in control group[92.0％ (23/25)vs 72.0％ (18/25),P＜0.05].Conclusion Torasemide is an effective and safe drug in treatment of encephaledema after acute cerebral hemorrhage.
