不同剂量甘露醇治疗中、重型颅脑损伤的临床价值分析

Clinical Value Analysis of Different Dosage of Mannitol in the Treatment of Moderate and Severe Craniocerebral Injury

目的旨在探讨不同剂量甘露醇治疗中、重型颅脑损伤的临床价值。方法选取我院2016年12月~2017年12月收治的54例中、重型颅脑损伤患者作为研究对象,根据甘露醇治疗剂量的不同,将患者分为对照组及观察组,每组患者27例。对照组采用125ml 20%甘露醇快速静脉滴注治疗,观察组患者采用250ml 20%甘露醇快速静脉滴注治疗。比较两组患者临床疗效及不良反应发生情况。结果观察组患者预后差者1例(3.70%),预后良好者26例(96.29%);对照组预后差者7例(25.92%),预后良好者20例(74.07%);两组患者预后情况存在明显差异,观察组预后良好率明显高于对照组(X^2=5.283,P=0.022)。观察组有效颅内压持续时间为(28.96±4.23)min,高于对照组(25.69±5.10)min,组间比较差异具有统计学意义(t=3.162,P<0.05);两组患者颅内压降低显效时间比较差异无统计学意义(P>0.05);两组患者在治疗过程中均未出现急性肾功能衰竭、腹痛、失眠等严重不良反应,对照组1例(3.70%)患者出现呕吐,观察组3例(11.11%)患者出现呕吐,两组患者不良反应发生率比较,差异无统计学意义(X^2=1.080,P=0.299)。结论 250ml 20%甘露醇快速静脉滴注治疗中、重型颅脑损伤患者有效颅内压持续时间长,临床效果佳,安全性高,值得临床推广。

Objective This study aimed to investigate the clinical value of different doses of mannitol in the treatment of moderate and severe craniocerebral injury.Methods A total of 54 cases with moderate and severe craniocerebral injury in our hospital from December 2016 to December 2017 were included and divided into control group and observation group according to different doses of mannitol,each with 27 cases.The patients in the control group were treated with rapid infusion of 125 ml 20%mannitol,and the observation group was treated with rapid infusion of 250 ml 20%mannitol.The clinical efficacy and adverse reactions of the two groups were compared.ResultsThere were 1 cases of poor prognosis in the observation group(3.70%),26 cases(96.29%)with good prognosis,7 cases in the control group(25.92%)and 20(74.07%)with good prognosis.There was significant difference in prognosis between the two groups,and the good prognosis rate in the observation group was significantly higher than that in the control group(X^2=5.283,P=0.022).The duration of effective intracranial pressure in the two groups was significantly different.The duration of effective intracranial pressure in the observation group was(28.96±4.23)min,which was higher than that of the control group(25.69±5.10)min,and the difference was statistically significant(t=3.162,P<0.05).There was no significant difference between the two groups of patients with intracranial pressure reduction(P>0.05).The two groups had no acute renal failure,abdominal pain,insomnia and other adverse reactions during the treatment.Among the control group,1 patients(3.70%)had vomiting,and 3 patients(11.11%)had vomiting in the observation group.There was no significant difference in the side effects between the two groups(X^2=1.080,P=0.299).Conclusion 250 ml 20%mannitol rapid intravenous drip for patients with moderate and severe craniocerebral injury has long duration of effective intracranial pressure,with good clinical effect and high safety.It is worthy of clinical promotion.