院前应用甘露醇对脑出血患者病死率的影响

The Influence of Pre-hospitalized Instilling the Mannitol on Cerebral Hemorrhage Patients' Fatality Rate

目的评价院前应用甘露醇对脑出血患者病死率的影响。方法收集2005年3月至2007年3月通过"120"绿色通道入住医院的脑出血患者,根据GCS评分结果分为三组,各组再根据院前处置措施的不同分为甘露醇组和生理盐水组。统计他们从发病至入院的时间、病死率,经统计学分析,得出相关结论。结果目前的院前处置措施(静脉快速滴注甘露醇)未对脑出血患者的病死率产生明显的影响,患者的病死率与疾病的严重程度呈正相关。结论由于院前干预时间大多在几十分钟,至多2小时,故院前应用甘露醇对脑出血患者的病死率无影响。脑出血发生后积极控制脑水肿,降低颅内压,为院内治疗赢得时间(比如手术清除血肿)仍是急性期脑出血治疗的重要环节,并且最好是采取就近治疗,尽量减少长途搬运。

Objective The purpose of the article is to evaluate the influence on pre-hospitalized instilling the mannitol on cerebral hem- orrhage patients＇ fatality rate. Methods Authors collected data about all cerebral hemorrhage patients who were hospitalized through “120” Green Passageway from March, 2005 to March, 2007, then divided them into three groups according to the GCS grading result, and divided each group into the mannitol group and physiological saline group according to the different pre-hospitalized interfering measures. We counted the length the time between the occurrence of hemorrhage and patients＇ hospitalization, and the fatality rate. A correlated conclusion was drawn from statistics analysis. Results It reveals that nowadays interfering measures （ instilling the mannitol fast through the vein） has no significant influence on patients＇ fatality rate. Patients＇ fatality rate is only related to the degrees their dis- eases. Conclusion In short,instilling the mannitol has no influence on patients＇ fatality rate because the time of handling is mostly no more than dozens of minutes, or at most, 2 hours. However,according to existing theories, controlling brain edema by medicines and reducing cerebrospinal pressure to gain time for some treatment （for example, removing the hematoma by operation） are still major methods to cure acute cerebral hemorrhage. And patients should be hospitalized in nearby hospitals to avoid long-distance transportation.