小剂量甘露醇防治迟发性外伤性颅内血肿的作用

The effect of small dosage manicol in prevention and cure of delayed traumatic Intracranial hematoma.

目的探讨迟发性外伤性颅内血肿的临床特征，发病机制，预防及治疗方法。方法对253例CT显示脑挫裂伤或蛛网膜下腔出血、颅骨骨折的患者随机分为A（对照组）、B（治疗组）两组。A组应用常规剂量甘霉醇[1．0g·kg^-1·（6-12h）^-1]脱水治疗，B组应用小剂量甘露醇[0．5g·kg^-1·（4—8h）^-1]脱水治疗。首次头CT后每间隔6h复查，观察两组患者迟发性血肿的发病率、72h的GCS评分及复查CT首次发现血肿的量。结果两组的GCS评分无显著性差异（P〉0．05）．B组的颅内迟发性血肿的发病率及血肿量〈A组（P〈0．05）。结论小剂量甘露醇能有效降低迟发性外伤性颅内血肿的发病率．及时动态复查头CT有利于早期防治。

Objective To discuss the clinical feature, pathogenesis, prevention and cure of delayed traumatic intracranial hematoma.Methods 253 cases with contusion and laceration of brain or subarachnoid hemorrhage, fracture of skull in CT scan were divided into group A （control group） and B （treatment group） randomly. Routine dosage manico] [1.0g·kg^-1·（6- 12h）^-1] was injected in group A,and small dosage manicol [0.5g·kg^-1·（4-8h） ^-1] in group B.Then repeated CT scan in all eases each 6h.Then observed the incidence rate; GCS score at 72h and the hematoma volume discovered for the first time. Results There was no significance of difference in GCS score between the two groups （ P 〉 0.05 ）, but the incidence rate and the hematoma volume of the treatment group were significantly lower than that of the control group （ P 〈 0.05） .Conclusion The application of small dosage manicol can decrease the incidence rate of delayed traumatic intracnmial hematoms,continuous and prompt CT scan to the skull will be benefit to the early diagnosis and therapy.