摘要
目的:以甘露醇作对照,探讨23.4％高渗盐水治疗不同程度颅内高压的效果。方法:对15名昏迷的、有侧脑室引流指征的脑出血患者进行共52例次降颅内压治疗。每次治疗随机决定静脉推注23.4％高渗盐水30 mL(HS组),或静滴20％甘露醇250 mL(Mannitol组)。持续监测用药前至用药后6h内的颅内压(ICP)。记录用药前的ICP、最大降幅和最大降幅百分比。结果:HS组:最大降幅与用药前的ICP之间有直线相关关系(P<0.01),最大降幅百分比与用药前的ICP之间无直线相关关系;Mannitol组:最大降幅、最大降幅百分比分别与用药前的ICP之间有直线相关关系(P分别<0.01、<0.05)。结论:23.4％高渗盐水和甘露醇均能安全、有效地降低颅内高压;但23.4％高渗盐水的降颅内高压效力比甘露醇稳定,尤其是当ICP升幅较小时,高渗盐水的降颅内压效力略高于甘露醇。
Objective: To compare the effects of 23.4% hypertonic saline with mannitol, used in patients with different degree intracranial hypertension. Methods: We presented 15 patients, who suffered with cerebral hemorrhage and had sign to have lateral ventricle drainage, and a total of 52 episodes of intracranial hypertension (IH). In every episode of IH, 23.4% hypertonic saline 30 mL (HS group) or 20% mannitol 250 mL (mannitol group) was used randomly by vessel. Intracranial pressure (ICP) was monitored from initiation of treatment to 6 hours flowing it. We recorded the ICP at initiation of treatment, the maximum decrease of ICP and the maximum decrease percent of ICP. Results: In HS group, the maximum decrease of ICP was positively correlated with the ICP at initiation of treatment (P< 0.01), and the maximum decrease percent of ICP was not correlated with the ICP at initiation of treatment. In mannitol group, the maximum decrease of ICP was positively correlated with the ICP at initiation of treatment (P<0.01), and the maximum decrease percent of ICP was positively correlated with the ICP at initiation of treatment too (P<0.05). Conclusion: Intracranial hypertension can be reduced effectively by using 23.4% hypertonic saline or mannitol. The effect of 23.4% hypertonic saline is more stable than mannitol. Especially slight intracranial hypertension can be cured more efficiently with 23.4% hypertonic saline than with mannitol.
出处
《岭南急诊医学杂志》
2004年第2期83-84,119,共3页
Lingnan Journal of Emergency Medicine
