术前应用大剂量甘露醇改善急性硬膜下血肿的临床预后评估

Prognostic evaluation of application of high-dose mannitol before operation to improve acute subdural hematoma

目的对急性硬膜下血肿患者术前应用大剂量甘露醇与常规剂量甘露醇进行预后评估。方法178例急性、创伤性硬膜下血肿患者被随机分成2组。术前紧急应用大剂量甘露醇组(研究组)91例,常规剂量甘露醇组(对照组)87例。结果术前散大瞳孔的改善研究组比对照组更多见、更明显(P<0.01)。对患者进行6个月术后随访,术前应用大剂量甘露醇组临床预后明显好于对照组(P<0.01)。结论术前紧急应用大剂量甘露醇可以明显改善急性硬膜下血肿患者的临床预后。

Objective To evaluate clinical prognosis for patients with acute subdural hematomas who received preoperative high-dose mannitol （HDM） treatment,as compared with that in patients who received preoperative routine-dose marmitol treatment.Methods 178 patients with acute traumatic subdural hematomas were randomly divided into two groups. 91 patients in observation group were treated by preoperative high-dose mannitol, however, the other 87 patients in control group were treated by preoperative routine-dose mannitol. Results The preoperative improvement of pupillary widening was significantly more frequent in observation group than that in control group （ P 〈 0.01） .After 6-month＇ s follow-up the patient＇s prognosis in observation group was superior to that in control group （ P 〈 0.01 ）. Conclusion The preoperative application of high-dose HDM can improve the prognosis of patients with acute subdural hematomas.