甘露醇对颅内血肿微创清除术患者疗效的影响

Research on Influence of Mannitol on Curative Effect after Intracranial Hematoma Microinvasive Removal

目的探讨甘露醇对脑出血血肿微创清除术后患者疗效的影响。方法将96例高血压脑出血血肿行微创清除术患者分为不用甘露醇组和用甘露醇组进行临床对比研究。结果不用甘露醇组48例中,恢复良好、生活能自理29例(60.42%),中残、部分生活自理12例(25.00%),重残5例(10.42%),死亡2例(4.17%);用甘露醇组48例中,恢复良好、生活能自理24例(50.00%),中残、部分生活自理14例(29.17%),重残6例(12.50%),死亡4例(8.33%)。手术1 d后复查头颅CT,不用甘露醇组血肿体积明显比用甘露醇组小,两组术后神经功能评分及血肿体积比较存在显著性差异(P<0.05)。结论颅内血肿微创清除术后不用甘露醇的治疗效果明显优于应用甘露醇,而甘露醇在颅内血肿微创清除术后需谨慎应用。

Objective To study the influence of mannitol on the curative effects after intracranial hematoma microinvasive removal.Methods Ninety-six cases of hematoma after hypertensive cerebral hemorrhage were given intracranial hematoma microinvasive removal.After the operation,the patients were divided equally into two groups.One group was given an injection of mannitol and another group was not.Then the clinical curative effects were evaluated and compared between the two groups.Results Among 48 cases in the group without using mannitol,29 cases（60.42%） recovered well with the ability of living independence,12 cases（25.00%） were mildly disabled with partial ability of living independence,5 cases（10.42%） were seriously disabled（including vegetative stage） and 2 cases（4.17%） died.Among 48 cases in using mannitol group,24 cases（50.00%） recovered well with the ability of living independence,14 cases（29.17%） were mildly disabled with partial ability of living independence,6 cases（12.50%） were seriously disabled（including vegetative stage） and 4 cases（8.33%） died.On postoperative 1 d,the cranial CT reexamination displayed that the hematoma volume in the group without using mannitol was obviously smaller than that in using mannitol group.The clinical nerves function scoring and hematoma volume after operation were statistically significant different between the two groups（P 0.05）.Conclusion After intracranial hematoma microinvasive removal,not using mannitol is superior to using mannitol in clinical curative effects.Mannitol must be carefully applied after intracranial hematoma microinvasive removal.