连续使用甘露醇治疗重型颅脑损伤患者颅内高压的临床研究

The clinical study of repeated use of mannitol to treat intracranial hypertension of the patients with severe craniocerebral injury

目的观察甘露醇反复长期使用后颅内压（ICP）的变化规律，以探讨甘露醇的有效使用方法。方法选择25例重型颅脑损伤患者术后ICP〈30mmHg的患者作为研究对象，予甘露醇静脉滴注，1．0g／（kg·次）／次，每4—6h1次，连续使用7d以上。同时应用颅内压监测仪持续监测ICP，并进行分析比较。结果用药后ICP均明显下降，至第7d仍能保持有效降颅压；但第2d开始治疗后ICP最低值高于第1d、ICP最大降幅百分比小于第1d，差异有显著性（P〈0．05）。结论连续使用甘露醇后降颅内高压的效力于第2d开始减弱，但至第7d仍能保持有效的降颅压。

Objective To investigate the changes of intracranial pressure（ICP） after long - term repeated use of mannitol,and explore the effective use of mannitol. Methods 25 patients experiencing operations after severe craniocerebral injury received intravenous 20% mannital（ 1g/ kg）, once in 4 - 6 hours, and given continuously monitoring of ICP for 7 days, when ICP was below 30 mmHg. Results ICP could be decreased significantly after the use of mannitol for 7 days,but the nadir of ICP after treatment in 2 -7 days were higher than those in the first day,and the maximum decrease percent of ICP were less than those in the first day（ P 〈 0.05 ）. Conclusion The descending effectiveness of ICP is active for 7 days after the repeated use of mannitol,but it begin to weaken from the second day.