甘露醇与复方甘油治疗高血压性脑出血的对比研究

A Comparative Observation of Effects of Mannitol and Compound Glycerin in Treatment of Acute Hypertensive Cerebral Hemorrhage

目的:比较复方甘油和甘露醇治疗急性高血压性脑出血的效果及安全性。方法:160例高血压脑性出血患者随机分为A组60例和B组100例,按病情严重程度分别给予不同剂量复方甘油和甘露醇治疗7-14 d后,比较2组血压、肾功能、副作用及死亡率。结果:A组血压下降不明显,死亡率高,但肾功能损伤较轻;B组血压显著下降,死亡率低,肾功能损伤较重。结论:高血压性脑出血急性期脱水治疗时,应考虑患者的年龄、心肾功能、血压以及病情程度,对于血压较高、中重度脑出血患者建议快速滴注甘露醇,而对于年龄偏大、心肾功能不佳者建议缓慢滴注复方甘油。

Objective.. To compare efficacy and safety of compound glycerin and mannitol in treatment of acute hiypertensive cerebral hemorrhage. Methods： 160 patients with acute hypertensive cerebral hemorrhage were randomly divided into group A （n=60） and B （n=100）, which were treated with different doses of compound glycerin or mannitol for 7 to 14 days respectively, according to the severity of the bleeding. The blood pressure, renal func- tions, side effects and mortality in the two groups were compared. Results： No significant differences of the blood pressure was observed between the two groups. The mortality in group A was statistically higher than that in group B, but incidence of renal insufficiency in group A was significantly lower than that in group B. Conclusion： The age, heart and renal functions, blood pressure, and severity of the disease should be considered in osmotherapy for patients with acute hypertensive cerebral hemorrhage. Mannitol is recommended for the patients with higher blood pressure or severer symptoms, and compound glycerin is more suitable for the elder patients or the patients with heart or renal insufficiency.