1例急性脑梗死并发脑水肿患者脱水治疗的病例分析

Case Analysis of Dehydration Treatment for One Patient with Acute Cerebral Infarction Complicated with Cerebral Edema

本文分析1例急性脑梗死并发脑水肿患者的脱水治疗方案,为临床合理使用脱水降颅压药物提供参考。该患者使用大剂量甘露醇脱水后出现急性肾损伤,换用人血白蛋白治疗,脑水肿并未见好转,药师建议再次给予小剂量甘露醇与其他脱水药物交替使用,患者脑水肿症状明显改善,未再出现肾损伤。提示小剂量的甘露醇与其他脱水药物交替使用可以在保证脱水疗效的同时,还避免急性肾损伤的发生;人血白蛋白不建议作为脑水肿脱水降颅压的常规治疗方案;临床药师可以通过专业的药物治疗知识优化药物治疗方案,提高疗效,减少不良反应的发生。

In this paper,the author analyzed the dehydration treatment for one patient with acute cerebral infarction complicated with cerebral edema in order to provide appropriate reference for the rational use of dehydrated drugs. The patient developed acute kidney injury（ AKI） after the dehydration treatment with high-dose of mannitol,and then was treated with albumin,however,the patient＇s cerebral edema was not improved. Clinical pharmacist recommended the alternate use of low-dose of mannitol and the other dehydrated drugs,and the patient＇s cerebral edema symptoms were significantly improved without AKI. The case suggested that the alternate use of low-dose of mannitol and the other dehydrated drugs could obtain better efficacy without AKI. Human serum albumin is not recommended as the routine treatment for dehydration. Clinical pharmacists can optimize the drug treatment program based on professional knowledge of drug therapy to improve the curative effect and reduce the occurrence of adverse reactions.