不同剂量的甘露醇对血浆渗透压的影响及其护理

Effect of different dosages of mannitol on plasma osmolarity and its nursing care

目的:观察不同剂量甘露醇对血浆渗透压的影响,以指导临床合理用药。方法:33例颅内压增高的病人随机分成两组,第一组17例,给予20%甘露醇0.5g/kg;第二组16例,给予20%甘露醇1.0g/kg,两组均6～8小时输注1次。监测两组病人每日首剂甘露醇前﹑后的血浆渗透压数值。结果:两组病人甘露醇使用前、后血浆渗透压差值比较差异有统计学意义(P<0.01)。连续多日反复使用甘露醇后,可引起血浆渗透压基础值逐渐增高,且使用时间越长,血浆渗透压基础值越高。结论:对于甘露醇,切莫盲目使用大剂量。从安全的角度考虑,提倡使用小剂量的甘露醇,有条件者应在用药期间监测血浆渗透压。加强用药过程中的护理,充分发挥其药理作用,使病人得到安全有效的治疗。

Objective：To explore the effect of different dosages of mannitol on plasma osmolarity in order to provide the basis for its reasonable use.Methods：Thlrty-three patients with high intraeranial pressure were randomly divided into two groups. Each patient received intravenous infusion of 0.5 g/kg mannitol, q.6-8 h,in group Ⅰ（n=17） and everyone received 1.0 g/kg mannitol,q.6-8 h,in group Ⅱ （n=16）.The plasma osmolarity was determined in all the patients. Results：There was significant difference in the plasma osmolarity before and after using mannitol in both the groups （P〈0.01）. The plasma osmolarity increased gradually with the increase in dosage of mannitol. Conclusion：Unrealistie use of large dose of mannitol should be forbidden. For the safety, the low dose of mannitol is worth advocating and plasma osmolarity should be monitored during using mannitol in the patients with high intraeranial pressure. Strengthening the attendenee during using mannitol and educing the pharmacologic action in extension could give patients a safe and more effective treatment.