高渗盐水与甘露醇治疗高血压脑出血术后颅内高压的临床疗效

Efficacy of hypertonic saline and mannitol in treatment of postoperative intracranial hypertension in patients with hypertensive intracerebral hemorrhage

目的比较3%高渗盐水和20%甘露醇降低高血压脑出血(HICH)术后颅内高压的效果。方法将30例高血压脑出血术后患者分为两组。观察组15例予以3%高渗盐水治疗,对照组15例予以20%甘露醇治疗;用药前至用药6h连续监测患者的颅内压(ICP)、平均动脉压(MAP)、中心静脉压(CVP),用药前至用药后3h测量患者血钠浓度及尿量。结果给药后观察组降颅压持续时间明显长于对照组(P<0.05);观察组脑灌注压(CPP)上升幅度明显大于对照组(P<0.05);给药后3h,观察组患者的尿量明显少于对照组(P<0.05)。结论 3%的高渗盐水可有效降低颅内压力,降颅压持续时间比20%甘露醇长,可为高血压脑出血术后降颅压使用。

Objective To compare the clinical ment of postoperative intracranial hypertension （HICH）. Methods effects of 3% hypertonic saline and 20% mannitol in treatin patients with hypertensive intracerebral hemorrhage Thirty patients undergone hypertensive cerebral hemorrhage surgery were randomly di vided into two groups. Fifteen patients of observation group were treated with 3 %hypertonic saline, other patients of control group were given 20% mannitol. The intracranial pressure （ICP）, mean arterial pressure （MAP）, central venous pressure （CVP） were continuously monitored before treatment and within 6 .hours after treatment; serum sodium concentration and urine volume were continuously measured before treatment and within 3 hours after treatment. Results The observation group had longer duration of decreasing ICP than the control group, comparison between the two groups showed statistical difference （ P 〈0.05）. The elevated range of cerebral perfusion pressure （CPP） in the observation group were more than that of the control group, comparison between the two groups showed statistically significant difference （ P 〈0.05）. The urine volume of the observation group within 3 hours after treatment was less than that of the control group, comparison between the two groups showed s line can reduce ICP effectively. ICP and can be used to down- tatistically significant difference （ P 〈0.05）. The duration of 3 % hypertonic saline is longer regulate intracranial pressure with HICH. Conclusion than 20 % 3 % hypertonic samannitol in reducing