甘露醇不同时机应用对脑出血患者预后的影响及其相关因素分析

The Effect of Mannitol Application at Different Times on the Prognosis of Patients with Cerebral Hemorrhage and an Analysis of Related Factors

目的:探讨甘露醇不同时机应用对脑出血患者预后的影响及其相关因素分析。方法:回顾性分析2017年1月至2020年12月间收治的80例原发性脑出血患者临床资料,其中40例入院6h前应用甘露醇纳入A组,40例入院6h后应用甘露醇纳入B组。对比两组患者预后情况,并根据预后情况分为预后良好组(58例)、预后不良组(22例),采用单因素分析、多因素Logistic回归分析脑出血患者预后的相关因素。结果:B组患者预后情况优于A组患者,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,高龄、发病至入院时间长、入院时NIHSS评分高、高GLU水平、出血量多为脑出血患者预后不良的独立危险因素(P<0.05),而入院时GCS评分高、CT显示中线未移位、未破入脑室、入院6h后应用甘露醇是脑出血患者预后良好的独立保护因素(P<0.05)。结论:入院6h后应用甘露醇治疗脑出血患者可获得更好预后,而年龄、发病至入院时间、入院时GCS评分、NIHSS评分、血糖、出血量、中线结构移位情况、破入脑室及甘露醇应用时机等为脑出血患者预后相关影响因素。临床治疗中需根据以上相关影响因素进行及时有效治疗以改善患者预后。

Objective:To explore the influence of mannitol application at different times on the prognosis of patients with cerebral hemorrhage and to analyze the related factors.Methods:The clinical data of 80 patients with primary cerebral hemorrhage admitted between January 2017 and December 2020 were retrospectively analyzed.Among them,40 patients were treated with mannitol 6 hours before admission and were included in group A,and 40 patients who were treated with mannitol 6 hours after admission were included to group B.The prognoses of the two groups of patients were compared before they were divided into a good prognosis group(58 cases)and a poor prognosis group(22 cases).Univariate analysis and multivariate logistic regression were used to analyze the prognostic factors of patients with cerebral hemorrhage.Results:The prognosis of patients in group B was better than that in group A,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that advanced age,long time from onset to admission,high NIHSS score at admission,high GLU level,and bleeding volume were mostly independent risk factors for poor prognosis in patients with cerebral hemorrhage(P<0.05),while GCS score at admission was high.CT image showed that the midline did not shift,did not break into the ventricle,and the application of mannitol 6 hours after admission was an independent protective factor for the good prognosis of patients with cerebral hemorrhage(P<0.05).Conclusion:Patients with cerebral hemorrhage treated with mannitol 6 hours after admission can get a better prognosis,and age,onset to admission,GCS score,NIHSS score,blood sugar,bleeding volume,midline structure shift,break into the ventricle,and mannitol application timing are related to the prognosis of patients with cerebral hemorrhage.In clinical treatment,timely and effective treatment should be carried out according to the above related factors to improve the prognosis of patients.