甘露醇联合地塞米松治疗感染性脑水肿患者的临床疗效及预后分析

Analysis on the Clinical Efficacy and Prognosis of Mannitol Combined with Dexamethasone in the Treatment of Patients with Infectious Cerebral Edema

目的分析甘露醇联合地塞米松治疗感染性水肿患者的临床疗效及预后。方法选择2014年12月至2017年6月我院收治的感染性脑水肿患者90例,随机分为两组各45例,对照组采用呋塞米注射液联合甘露醇治疗,观察组采用甘露醇联合地塞米松治疗。比较两组患者治疗前后的一氧化氮(NO)、肿瘤坏死因子α(TNF-α)、白细胞介素1 (IL-1)水平,对患者进行6个月的随访,观察患者的病死率及并发症发生率。结果治疗前,两组患者的NO、 TNF-α和IL-1水平比较,差异无统计学意义(P>0.05);治疗后两组患者的NO、 TNF-α和IL-1水平均较治疗前显著降低(P <0.05),且观察组治疗后的NO、 TNF-α和IL-1水平均显著低于对照组(P <0.05)。随访期间,观察组的并发症发生率为11.11%,明显低于对照组的40.00%(P <0.05);观察组的病死率为2.22%,明显低于对照组的13.33%(P <0.05)。结论甘露醇联合地塞米松治疗感染性脑水肿患者具有显著的临床疗效,可有效降低炎性因子表达,降低并发症发生率及病死率,改善患者的预后。

Objective To analyze the clinical efficacy and prognosis of mannitol combined with dexamethasone in the treatment of patients with infectious cerebral edema. Methods 90 cases of patients with infectious cerebral edema admitted to our hospital from December 2014 to June 2017 were selected and randomly divided into two groups, with 45 cases in each group. The control group was treated with furosemide injection combined with mannitol, while the observation group was treated with mannitol combined with dexamethasone. Before and after treatment, the levels of nitric oxide (NO), tumor necrosis factor alpha (TNF-α) and interleukin-1 (IL-1) were compared between the two groups. All patients were followed up for 6 months, to observe the mortality rate and incidence of complications. Results Before treatment, no statistical difference was found between the two groups in the levels of NO, TNF-αand IL-1 (P >0.05);After treatment, both groups had significantly decreased NO, TNF-αand IL-1 levels (P <0.05), and the levels of NO, TNF-αand IL-1 of the observation group were significantly lower than those of the control group (P <0.05). During follow-up, the incidence of complications of the observation group was 11.11%, significantly lower than 40.00% of the control group (P <0.05);The mortality rate of the observation group was 2.22%, significantly lower than 13.33% of the control group (P <0.05). Conclusions Mannitol combined with dexamethasone in the treatment of patients with infectious cerebral edema has significant clinical efficacy, which can effectively reduce the expressions of inflammatory factors, reduce the mortality rate and incidence of complications, and improve the prognosis of patients.