甘露醇应用时间对丘脑出血血肿的影响

Timing of mannitol use on hematoma in thalamic hemorrhage

目的探讨甘露醇对脑出血早期血肿扩大的影响及如何正确使用甘露醇。方法选择300例丘脑脑出血、入院在3 h以内,经CT检查出血量在60 ml以内的患者,无脑疝迹象,分为即刻应用甘露醇组(150例)和12 h后用甘露醇组(150例)。72 h复查脑CT,血肿增大超过33%为早期血肿扩大,分析发病12 h内应用甘露醇对早期血肿扩大的影响。结果发病12 h内使用甘露醇组发生血肿扩大106例,12 h后用甘露醇组26例,两者比较差异有非常显著意义(P<0.01)。结论高血压脑出血患者发病12 h内不适当应用甘露醇可增加早期血肿扩大的发生率,使病情加重。对于脑压增高没有危及生命的患者,尤其发病12 h内的高血压性脑出血患者,不宜盲目使用甘露醇,以免使血肿扩大,加重病情。

Objective To investigate the effect of mannitol in treating thalamit hemorrhage and its correct application. Methods Three hundred patients with thalamic hemorrhage admitted with in three hours, with less than 60 ml blood loss and with no herniation were divided into those given given mannit＇ol immediately and mannitol after 12h CT scan was performed on admision repeated 72 latex. Results One hundred and six patients in the group given mannitol withim 12h had hematoma enlarged, while only 26 patients had hematoma enlarged when given mannitol after 12 h. There was significant difference in the two groups （ P 〈 0. 01 ）. Conclusion Mannitol given within 12 h will increase the risk of early hematoma enlargement in thalamic hemorrhage and aggravate deteriorate the disease.