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甘露醇治疗急性脑梗死临床价值的探讨 被引量:11

Discussion on clinical efficacy of mannitol in treating acute cerebral infarction
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摘要 目的 :评价甘露醇治疗急性期脑梗死的疗效及应用时机对预后的影响。方法 :B组 384例给低分子右旋糖酐、复方丹参、胞磷胆碱、硫酸镁及尼莫地平等常规药物治疗。A组 387例用 2 0 %甘露醇 12 5~ 15 0mL ,iv ,gtt,q 6~ 12h ,2 4h <6 0 0mL ,7~ 10d为一个疗程 ,余治疗同B组 ;根据用甘露醇起始时间不同 ,又分为A1组 192例在 2 5~ 72h内用 ,A2 组 195例在 2 4h内用。结果 :(1) 3组卒中量表 (CSS)分值 2 4h内均有增加 ,但A1和A2 组增加明显 ,从高到低依次为A2 >A1>B组 ;且A2 组CSS持续增至 3d ,随后至 7d急剧下降。 7d后 3组CSS均渐下降 ,总体上依次为B >A1>A2 组 ,有可比性。 (2 )A ,B 2组间疗效比较经Ridit分析 ,差异有非常显著意义 (P <0 .0 1)。结论 :急性脑梗死轻中症病人 ,应用甘露醇治疗组较不用组疗效差 ,表现为疗后 72h内进展型卒中病人明显增加 ,影响随后早期及近中期病人神经功能的恢复 。 AIM: To evaluate the therapeutic effect of mannitol in treating acute cerebral infarction and the influence of its therapeutic opportunity on prognosis. METHODS: B group, three hundred and eighty four patients , was treated with usual drugs such as dextran 40, salvia miltiorrhizae composita, citicoline, magnesium sulfate, nimodipine, etc. A group, three hundred and eighty seven patients, was added with 20% mannitol 125 150 mL iv, gtt, q 6 12 h, total below 600mL in 24 h basis of B group. One course of treatment was 7 10 d. A group was made up of A 1 and A 2 sub groups according to the using time with mannitol. A 1 sub group, one hurdred and ninty two patients, was used with mannitol in 25 72 h and A 2 sub group, one hundred and ninty five patients, was used within 24 h. RESULTS: (1) CSS (Chiness stroke scale) of all three groups increased within 24 h, especially A 1 and A 2(A 2>A 1>B); CSS of A 2 didn't descend rapidly until 3 d. CSS of all three groups descended 7 d later,(B>A 1>A 2). There was significant difference. (2) There was a very significant difference in effect between A and B group( P <0.01) by Ridit analysis. CONCLUSION: The therapeutic effect of A group (with mannitol) is worse than that of B group (without mannitol) on acute light mediate cerebral infarction. It shows that the number of patients expanding stroke increases obviously in 72 h after treatment and mannitol affects the recover of patients' nervous function on the early and middle period patients. The earlier the patients are treated with mannitol, the worse the prognosis is.
出处 《中国新药与临床杂志》 CAS CSCD 北大核心 2003年第11期679-682,共4页 Chinese Journal of New Drugs and Clinical Remedies
关键词 甘露醇 脑梗死 预后 药物评价 mannitol brain infarction prognosis drug evaluation
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