甘油果糖联合甘露醇治疗脑水肿的临床研究(1)
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【摘要】 目的 观察甘油果糖联合甘露醇治疗脑水肿的临床疗效及其对肾功能的影响。方法 将自2008年3月至2010年5月来我科治疗的89例脑水肿患者随机分为观察组和对照组,其中观察组45例,给予甘油果糖联合甘露醇治疗,对照组44例,给予甘露醇治疗。观察临床疗效和对肾功能的影响情况。结果 观察组和对照组治疗脑水肿的效果相似,差异无统计学意义(P>0.05),但是甘油果糖联合甘露醇能显著减轻对肾功能的损害,差异有统计学意义(P<0.05)。结论 甘油果糖联合甘露醇治疗脑水肿与单独使用甘露醇具有相似的临床效果,但是可以明显减轻对肾功能的损害等,不良反应小,值得推广应用。
【关键词】脑水肿;甘油果糖;甘露醇;联合治疗
The study of glycerin and fructose combined with mannitol in treatment of cerebral edema
SUN Zhi-guo.Department of neurology,Eighth People’s Hospital of Zibo City,Shandong Province,Zibo 255000,China
【Abstract】 Objective To observe the therapeutic effect and clinical effect on renal function of glycerin and fructose combined with mannitol in treatment for Cerebral edema.Methods 89 cases of cerebral edema in our department since March 2008~May 2010 were randomly divided into two groups,the observation group(45cases)were treated by glycerin and fructose combined with mannitol,and the control group(44 cases)were treated by mannitol.Observe the clinical effects and the change of the renal function.Results The clinical effect of the observation group and control group was similar,and the difference was not statistically significant(P>0.05); but glycerin and fructose combined with mannitol can significantly reduce renal damage,the difference was statistically significant(P<0.05).Conclusion The effect of glycerin and fructose combined with mannitol in treatment of Cerebral edema is similar to that of mannital given only,but it can significantly reduce the damage to renal function,and the side effect is lower,it is worth to promote.
【Key words】Cerebral edema; Glycerol and fructose; Mannitol; Combination therapy
脑水肿是由许多神经科的疾病所伴发的一种最常见的病症,常可由颅脑创伤、脑肿瘤、颅脑感染及脑血管病等引起,患者可出现一系列的临床症状,严重者会出现严重的后遗症甚至死亡。如果治疗得当,将会大大降低脑水肿患者的致死、致残率。目前临床上比较认同的方案是应尽快降低颅内压,作者单位:255000山东省淄博市第八人民医院神经内科
减轻脑水肿,进而有效缓解脑水肿患者症状,改善预后[1],而应用甘露醇、甘油果糖作为控制脑水肿、降低颅内压的一个重要手段,现已广泛用于脑水肿的治疗。我科将甘油果糖联合甘露醇与单独应用甘露醇治疗脑水肿的疗效及不良反应进行了比较,现将结果报告如下。
1 资料与方法
1.1 临床资料 自2008年3月至2010年5月来我科治疗的89例脑水肿患者,其中男47例,女42例,年龄最大为71岁,最小为18岁,平均45.7岁。颅脑创伤术后转入我科30例,颅脑良性肿瘤切除术后27例,脑梗死所致17例,颅脑感染所致8例,急性低钠血症所致5例,铅中毒所致例。患者治疗前均行脑CT或MRI检查,结合相应的临床表现确诊为脑水肿,并且无心、肝、肾等脏器功能衰竭等病史,可以耐受该疗法。将患者随机分为观察组和对照组,观察组45例,对照组44例,两组患者性别、年龄、病情等差异无统计学意义(P>0 ......
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