甘露醇联合高渗盐水对小儿颅内感染的降颅压作用

Effect of Mannital Combined with Hypertonic Saline in the Treatment of Intracranial Hypertension for Children with Intracranial Infection

目的:探讨甘露醇联合高渗盐水在小儿颅内感染降颅压中的疗效。方法:将我院2012-2014年收治的106例颅内感染患儿,随机分为A、B、C三组,A组给予20%甘露醇注射液q 4 h降颅压,B组给予20%甘露醇q 6 h降颅压,C组给予20%甘露醇q 6 h+3%高渗盐水q 12 h,比较三组患儿治疗后5 d的脑脊液压力变化、临床症状改善情况、不良反应等。结果:A组患儿在脑脊液压力下降、颅内高压临床症状改善方面优于B组(P<0.05);C组降颅压效果与A组比较差异无统计学意义(P>0.05)。A组肾功损害和电解质紊乱发生率明显高于B组和C组(P<0.05),C组与B组肾功损害发生率比较差异无统计学意义(P>0.05),但C组电解质紊乱发生率低于B组(P<0.05)。结论:在治疗小儿颅内感染中甘露醇联合高渗盐水与传统单用甘露醇相比,在降低颅内压及改善颅内高压临床症状上有较好的疗效,并且肾功能损害和电解质紊乱等不良反应发生率低。

Objective： To discuss the effect of mannital combined with hypertonic saline on decreasing the intracranial pressure in children with intracranial infection. Methods： One hundred and six children with intracranial infection admitted to hospital in 2012 to2014 were prospective analyzed. They were divided into group A（ n = 34） treated with 20% mannitol q 4 h,group B（ n = 36） treated with 20% mannitol q 6 h,and group C（ n = 36） treated with 20% mannital q 6 h combined with 3% hypertonic saline. We comparedthe differences of intracranial pressure decreasing,improvement of clinical symptoms,and adverse reactions caused by medication between the three groups after 5 days ＇ treatment. Results： Group A have better effect on intracranial pressure decreasing and improvement of clinical symptoms than group B（ P〈0. 05）,there were no obvious differences between group C and group A（ P〉0. 05）.The incidences of renal damage and electrolyte disturbance in group A were higher than these in group B and group C（ P〈0. 05）,there were no obvious differences between group C and group A（ P〉0. 05）. Conclusion： The efficacy of mannital combined with hypertonic saline on reducing intracranial pressure and improving clinical symptoms of intracranial hypertension are better than that of traditional mannitol alone in children with intracranial infection. The incidences of renal dysfunction and electrolyte disturbance are lower.