复方甘油与甘露醇治疗36例婴幼儿重症肺炎合并脑病的对比分析

The comparative analysis of 36 cases of infants with severe pneumonia complicating the cerebropathy treated with glycerin and the mannitol

目的:比较复方甘油果糖与甘露醇治疗婴幼儿重症肺炎合并脑病的抗脑水肿疗效以及不良反应和对心肺功能的影响。方法:将36例重症肺炎合并脑病的婴幼儿随机分为甘油组和甘露醇组,分别在综合治疗基础上静脉给予10%甘油果糖或20%甘露醇5ml/kg,重度6～8h1次,轻、中度12h1次。结果:甘露醇和复方甘油均发挥抗脑水肿的作用,但两组之间的疗效差异无统计学意义(P>0.05);甘油组肾功能损害明显低于甘露醇组(P<0.05),重症肺炎的恢复时间明显短于甘露醇组(P<0.05)。结论:甘油为治疗婴幼儿重症肺炎合并脑病有效、安全、方便的理想药物,对心肺功能影响小;而甘露醇对心肺功能影响大,延长肺炎恢复时间,除极需迅速降低颅内压、抢救脑疝外不建议选用。

Objective：To compare the curative effects of the glycerin fructose and mannitol on resisting hydrocephalus, their side effects and the influence on the cardiorespiratory function of the infants with severe pneumonia complicated with the cerebropathy.Methods：36 infants with severe pneumonias combining brain diseases were divided into glycerin and mannitol groups randomly.On the basis of the synthetic treatment, these infants were treated with 10% glycerin fructose or 20% mannitol （5 ml/kg） through intravenous respectively.The severest cases were treated once every 6 to 8 hours, others were treated once every 12 hours.Results：Both of the mannitol and glycerin played an equal role to resist hydrocephalus, there was no significant difference between their curative effects （P〉0.05）.However, the damages of renal function in glycerin group were lower than that of the mannitol group obviously （P〈0.05）, and recovery phase of the severe pneumonia in glycerin group was also shorter than that of mannitol group notably （P〈0.05）.Conclusion：Glycerin is an effective, safe and convenient medicine to treat the pneumonia complicating the cerebropathy in the infants, and has little effect on the cardiorespiratory function.However, the mannitol not only has more effect on the cardiorespiratory function, but also prolongs the recovery period of the pneumonia.Thus mannitol is not recommended to lower intracranial pressure, or to rescue cerebral hernia extremely.