甘露醇应用时机对中等量脑出血患者疗效及相关指标的影响
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篇名: 甘露醇应用时机对中等量脑出血患者疗效及相关指标的影响
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摘要: 目的:探讨甘露醇应用时机对中等量脑出血患者疗效及相关指标的影响。方法:回顾性收集280例中等量脑出血患者资料,按甘露醇应用时机的不同分为超早期组(65例)、早期组(97例)和延期组(118例)。所有患者均给予内科保守治疗和营养脑细胞等对症支持治疗。在此基础上,超早期组患者于脑出血6 h内给予甘露醇注射液;早期组患者于脑出血6~24 h给予甘露醇注射液;延期组患者于脑出血24 h后给予甘露醇注射液。比较各组患者的临床疗效,血肿扩大发生率、病死率、继续出血/再出血发生率及不良反应发生情况。结果:早期组和延期组患者血肿扩大发生率、病死率均显著低于超早期组,差异均有统计学意义(P<0.05),但早期组与延期组间差异均无统计学意义(P>0.05)。早期组患者总有效率显著高于超早期组和延期组,继续出血/再出血发生率显著低于超早期组和延期组,差异均有统计学意义(P<0.05),但超早期组与延期组间差异均无统计学意义(P>0.05)。各组患者用药期间均未见明显不良反应发生。结论:在常规治疗的基础上,中等量脑出血患者在脑出血6~24 h应用甘露醇的疗效相对超早期和延期用药较好,可降低继续出血/再出血发生率,且安全性相当。
ABSTRACT: OBJECTIVE: To explore the effect of administration timing of mannitol on efficacy and related indexes of patients with moderate cerebral hemorrhage. METHODS: Data of 280 patients with moderate cerebral hemorrhage being treated with mannitol were divided into super-early group (65 cases), early group (97 cases) and extension group (118 cases) was analyzed retrospectively according to administration timing. All patients received conservative medical treatment, ntrition brain cells and other symptomatic and supportive treatment. Based on it, super-early group received mannitol within 6 h of cerebral hemorrhage, early group received mannitol within 6-24 h, and extension group received mannitol more than 24 h. Clinical efficacy, incidence of hematoma enlargement, mortality, incidence of continued bleeding/rebleeding and incidence of adverse reactions in 3 groups were observed. RESULTS: The incidences of hematoma enlargement and mortality in early group and extension group were significantly lower than super-early group, the differences were statistically significant (P<0.05); but there were no significant differences between early group and extension group (P>0.05). The total effective rate in early group was significantly higher than super-early group and extension group, the incidence of continued bleeding/rebleeding was significantly lower than super-early group and extension group, the differences were statistically significant (P<0.05); but there no significant differences between super-early group and extension group (P>0.05). CONCLUSIONS: Based on conventional treatment, mannitol shows better efficacy for patients with moderate cerebral hemorrhage within 6-24 h of cerebral hemorrhage than those in super-early or extension. It can reduce continued bleeding/rebleeding incidence, and has equivalent safety.
期刊: 2016年第27卷第21期
作者: 郭作隆,邹兴军
AUTHORS: GUO Zuolong,ZOU Xingjun
关键字: 甘露醇;应用时机;中等量脑出血;继续出血/再出血;疗效
KEYWORDS: Mannitol; Administration timing; Moderate cerebral hemorrhage; Continued bleeding/Rebleeding;Efficacy
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