托拉塞米或呋塞米联合甘露醇治疗急性脑出血患者脑水肿的效果观察

Effect of torasemide or furosemide combined with mannitol in treatment of acute cerebral hemorrhage patients with cerebral edema

目的 比较托拉塞米或呋塞米联合甘露醇治疗急性脑出血患者脑水肿的疗效.方法 选择脑出血患者160例,按治疗方法不同分为托拉塞米组和呋塞米组,每组80例,托拉塞米组采用托拉塞米联合20％甘露醇治疗,呋塞米组采用呋塞米联合20％甘露醇治疗,比较两组疗效、甘露醇用量、水肿体积、24h尿量及不良反应.结果 托拉塞米组总有效率明显高于呋塞米组[97.5％（78/80）比77.5％（62/80）],甘露醇用量明显少于呋塞米组[（347.5±32.5） ml比（438.2±30.7） ml],不良反应发生率明显低于呋塞米组[7.5％（6/80）比27.5％（22/80）],差异均有统计学意义（P＜ 0.01或＜0.05）.托拉塞米组治疗第7,14天水肿体积明显小于呋塞米组[（21.1±3.4）ml比（23.3±4.8） ml、（17.6±4.5） ml比（22.4±5.6）ml],治疗第3,7,14天24h尿量明显多于呋塞米组[（3684±528） ml比（3 429±592） ml、（3 854±746） ml比（3 185±490）mnl、（3 742±658） ml比（2 251±324） ml],差异均有统计学意义（P＜0.05）.结论 托拉塞米在治疗急性脑出血患者的脑水肿方面较呋塞米疗效确切,安全性好.

Objective To compare the effect of torasemide or furosemide combined with mannitol in the treatment of acute cerebral hemorrhage patients with cerebral edema.Methods One hundred and sixty patients with cerebral hemorrhage were selected,and divided into torasemide group and furosemide group according to different treatment methods,40 cases in each.The torasemide group was treated with torasemide combined with 20% mannitol,the furosemide group was treated with furosemide combined with 20% mannitol.The curative effect,mannitol dosage,edema volume,24 h urine and adverse reactions in two groups were compared.Results The total effective in torasemide group was higher than that in furosemide group [97.5% （78/80） vs.77.5% （62/80）],mannitol dosage was less than that in furesemide group [（347.5 ±32.5） ml vs.（438.2 ±30.7） ml],the incidence of adverse reactions was lower than that in furosemide group [7.5%（6/80） vs.27.5%（22/80）],which reached statistical significance （P〈 0.01 or 〈 0.05）.The edema volume in the 7th,14th day in torasemide group was less than those in furosemide group [（21.1 ±3.4） ml vs.（23.3 ±4.8） ml,（17.6 ±4.5） ml vs.（22.4 ±5.6） ml],the 24 h urine in the 3re,7th,14th day were more than those in furosemide group [（3 684 ±528） ml vs.（3 429 ±592） ml,（3 854 ± 746） ml vs.（3 185 ±490） ml,（3 742 ±t658） ml vs.（2 251 ± 324） ml],which reached statistical significance （P 〈 0.05）.Conclusions Torasemide in treatment of acute cerebral hemorrhage patients has better efficacy and safety.It is better than furosemide.