甘露醇治療早期腦出血對(duì)血腫擴(kuò)大及預(yù)后的影響

彭亮

摘要：目的 ?觀察甘露醇治療早期腦出血對(duì)血腫擴(kuò)大及預(yù)后的影響。方法 ?選取2018年2月～2019年2月在我院診治的86例早期腦出血患者為研究對(duì)象，采用隨機(jī)數(shù)字表法分為對(duì)照組和觀察組，各43例。對(duì)照組于發(fā)病6 h內(nèi)使用甘露醇治療，觀察組于發(fā)病6 h后使用甘露醇治療，比較兩組治療總有效率、治療前后認(rèn)知功能MMSE評(píng)分、血腫擴(kuò)大率、病死率及生活質(zhì)量總評(píng)分。結(jié)果 ?觀察組臨床治療總有效率為93.02%，高于對(duì)照組的81.39%（P<0.05）;治療后兩組MMSE評(píng)分均低于治療前（P<0.05），但治療后觀察組與對(duì)照組比較（P>0.05）;觀察組血腫擴(kuò)大率、病死率均低于對(duì)照組，治療后生活質(zhì)量總評(píng)分高于對(duì)照組（P<0.05）。結(jié)論 ?過(guò)早給予早期腦出血患者甘露醇治療，可能影響治療效果，加重血腫擴(kuò)大，影響患者預(yù)后。

關(guān)鍵詞：甘露醇;早期腦出血;血腫;預(yù)后

中圖分類號(hào)：R743.34 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻(xiàn)標(biāo)識(shí)碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2020.17.046

文章編號(hào)：1006-1959（2020）17-0155-02

Abstract：Objective ?To observe the effect of mannitol treatment of early cerebral hemorrhage on hematoma expansion and prognosis.Methods ?86 patients with early cerebral hemorrhage who were diagnosed and treated in our hospital from February 2018 to February 2019 were selected as the research objects， and were divided into control group and observation group by random number table method， with 43 cases in each group. The control group was treated with mannitol within 6 h of onset， and the observation group was treated with mannitol within 6 h of onset. The total effective rate of treatment， cognitive function MMSE score before and after treatment， hematoma expansion rate， fatality rate and total quality of life were compared between the two groups.Results ?The total effective rate of clinical treatment in the observation group was 93.02%， which was higher than 81.39% in the control group （P<0.05）; the MMSE scores of the two groups after treatment were lower than those before treatment （P<0.05）， but the observation group was compared with the control group after treatment （P>0.05）; the hematoma enlargement rate and fatality rate of the observation group were lower than those of the control group， and the total quality of life score after treatment was higher than that of the control group （P<0.05）.Conclusion ?Premature administration of mannitol to patients with early cerebral hemorrhage might affect the therapeutic effect， aggravated hematoma enlargement， and affected the prognosis of patients.

Key words：Mannitol;Early cerebral hemorrhage;Hematoma;Prognosis

腦出血（cerebral hemorrhage）是腦血管疾病常見(jiàn)的急癥，其病因主要為腦水腫，引起顱內(nèi)壓升高，形成腦疝，誘發(fā)腦出血的發(fā)生。目前，臨床治療早期腦出血的原則是減少腦水腫，降低顱內(nèi)壓，避免腦部壓力過(guò)大，引發(fā)繼發(fā)性腦出血。常規(guī)用藥為甘露醇，該藥具有較好的脫水降壓效果，但其用藥時(shí)機(jī)并未進(jìn)行明確規(guī)定和界定。已有研究顯示[1]，甘露醇治療可能利于減輕腦出血患者癥狀，影響臨床預(yù)后效果，但對(duì)早期腦出血治療療效、預(yù)后的具體影響存在爭(zhēng)議。本研究結(jié)合2018年2月～2019年2月在我院診治的86例早期腦出血患者臨床資料，觀察甘露醇治療早期腦出血對(duì)血腫擴(kuò)大及預(yù)后的影響，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料 ?選取2018年2月～2019年2月在天津市東麗區(qū)東麗醫(yī)院診治的86例早期腦出血患者為研究對(duì)象，采用隨機(jī)數(shù)字表法分為對(duì)照組和觀察組，各43例。……