快速静滴硝普钠和甘露醇抢救脑水肿并发肺水肿的疗效

Therapeutic effects of sodium nitroprusside and mannitol on pulmonary edema complicated by cerebral edema

目的：探讨快速静脉滴注硝普钠（ＳｏｄｉｕｍＮｉｔｒｏｐｒｕｓｓｉｄｅ，ＳＮＰ）和甘露醇（Ｍａｎｎｉｔｏｌ）治疗脑水肿并发肺水肿的疗效。方法：对１５例患者在心电监护下给予ＳＮＰ５０ｍｇ加入１０％葡萄５００ｍＬ静滴，剂量从３００μｇ／ｍｉｎ开始，根据血压调整逐渐减量；１５ｍｉｎ后给予２０％Ｍａｎｎｉｔｏｌ１２５～２５０ｍＬ静滴，２ｈ后重复Ｍａｎｎｉｔｏｌ剂量。结果：临床总有效率７３．３％，治疗后ＨＲ、ＢＰ明显降低（Ｐ＜０．００１），ＰａＯ２、ＳａＯ２明显升高（Ｐ＜０．００１）。

Objective:To study the effects of sodium nitroprusside(SNP)and mannitol in the treatment of cerebral edema associated with pulmonary edema in emergency.Methods:Under ECG monitoring,15 patients were given 50mg of SNP diluted in 10% glucose 500 mL intravenously at the initial rate of 300ug/min and the speed of dripping was gradually slowed down according to the BP readings.15 minutes later 125～250 mL of 20% mannitol solution was started through venous route and repeated once more after 2 hours.Results:Clinically the total efficiency was 73.3%.After administration of the drugs both HR and BP markedly decreased( P< 0.001),and both PaO 2 and SaO 2 significantly increased ( P< 0.001).Conclusion:Rapid intravenous drip of SNP followed by mannitol is of valid efficacy on pulmonary edema complicated by cerebral edema.