甘露醇对脑出血后脑水肿的影响

Influence of mannitaol on brain edema after cerebral hemorrhage

目的探讨甘露醇对脑出血后脑水肿的影响。方法对入选的51例脑出血患者进行回顾性分析,将其分为发病24小时内入院应用甘露醇组(35例)和24小时后入院应用甘露醇组(16例);48小时和2周后复查脑CT,通过对比脑水肿的变化,分析脑出血发病24小时内应用甘露醇对脑水肿的影响。结果发病24小时内使用甘露醇组48小时出现脑水肿加重者5例(14.3%),2周后21例(60.0%);24小时后使用甘露醇组48小时出现脑水肿加重者1例(6.3%),2周后3例(18.8%)。两者48小时CT比较差异无显著意义(P>0.05),2周后CT比较差异有非常显著意义(P<0.01);2周后疗效比较差异有显著意义(P<0.05)。结论脑出血患者发病24小时内不适当应用甘露醇可使脑水肿和病情加重。因此,脑出血患者早期使用甘露醇应慎重。

Objective To investigate the influence of mannitol on brain edema after cerebral hemorrhage.Methods The data of 51 patients with cerebral hemorrhage were retrospectively analyzed. 51 patients were randomly divided into two groups, group A （n=35） was treated with mannitol within 24 hours ,and group B （n=16） was treated with mannitol after 24 hours. Cranial CT was performed in 48 hours and 2 weeks. The influence of using mannitol within 24 hours after the onset on brain edema was analyzed. Results 5（14.3%） patients in group A had exacerbation on brain edema in 48 hours and 21 （60.0%） patients in 2 weeks, however, 1（6.3%） patients in group B had exacerbation of brain edema in 48 hours and 3（18.8%） patients in 2 weeks. There was no significant difference in cranial CT in 48 hours between the two groups （P〉0.05）,there was a significant difference in cranial CT after two weeks between two groups （P〈0.01）. There was a significant difference in the therapeutic effect after two weeks between two groups （P〈0.05）. Conclusion The improper application of mannitol within 24 hours after the onset in patients with cerebral hemorrhage may increase the incidence of exacerbation of brain edema and may exacerbate patient＇s condition. For patients with cerebral hemorrhage within 24 hours after the onset, mannitol should be used prudently in order to prevent the disadvantage.