高血压性脑出血患者使用甘露醇治疗早期血肿扩大的观察分析

Influence of mannitol on early hematoma enlargement in patients with hypertensive cerebral hemorrhage

目的探究分析甘露醇对高血压性脑出血患者早期血肿扩大的影响。方法选取我院在2014年至2015年期间收治的120例高血压性脑出血患者,将其分为观察组与对照组各60例,观察患者发病发12h内应用甘露醇250ml静脉滴注,对照组患者发病24h内仅接受呋塞米40mg静脉滴注1～2次,发病24h后据患者病情酌情使用甘露醇进行治疗。分析并对比两组患者颅内压、脑血肿以及脑水肿情况。结果观察组发生血肿扩大的患者共26例,占43.3%,对照组中发生血肿扩大的患者共5例,占8.3%,,明显要少于观察组患者（P〈0.05）。结论高血压性脑出血患者早期使用甘露醇,会增加早期血肿扩大的发生率,加重患者的病情。因此,高血压性脑出血患者早期不可盲目应用甘露醇,应在发病24h后根据患者病情酌情使用甘露醇。

Objective To investigate the influence of mannitol on early hematoma enlargement in patients with hypertensive cerebral hemorrhage. Methods A total of 120 patients with hypertensive cerebral hemorrhage who were admitted to our hospital from 2014 to 2015 were enrolled and divided into observation group and control group, with 60 patients in each group. The patients in the observation group were given intravenous drip of mannitol 250 ml within 12 hours after onset; those in the control group were only given intravenous drip of furosemide 40 mg 1-2 times within 24 hours after onset and mannitol was given after 24 hours based on patients＇ condition. The intracranial pressure,cephalophyma, and cerebral edema were compared between the two groups. Results The observation group had a significantly higher proportion of patients with hematoma enlargement than the control group [26（43.3%） vs 5（8.3%）, P〈0.05]. Conclusion Early application of mannitol in patients with hypertensive cerebral hemorrhage can increase the incidence of early hematoma enlargement and aggravate patients＇ condition. Therefore, mannitol cannot be used blindly in patients in the early stage of hypertensive cerebral hemorrhage and should be used after 24 hours based on patients＇ condition.