| 柴磊 杨彦龙 孙红星 艾鑫 李立宏.等渗透剂量的7.5%高渗盐水和20%甘露醇治疗颅内高压疗效的对比研究[J].,2015,15(29):5728-5731 |
| 等渗透剂量的7.5%高渗盐水和20%甘露醇治疗颅内高压疗效的对比研究 |
| Comparison of 7.5%Hypertonic Saline and 20%Mannitol in Doses ofSimilar Osmotic Burden for Treatment with Intracranial Hypertension |
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| DOI： |
| 中文关键词: 高渗盐水 甘露醇 颅内压 |
| 英文关键词: Hypertonic saline Mannitol Intracranial pressure |
| 基金项目:陕西省科学技术研究发展计划项目课题（2013K12-01-7） |
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| 中文摘要: |
| 目的：比较等渗透剂量的7.5 %高渗盐水(hypertonic saline, HTS)和20 %甘露醇治疗颅高压的疗效。方法：当患者的颅内压
(intracranial pressure, ICP)超过20 mmHg时，一组患者接受了4 mL/kg 7.5%HTS(HTS 组，n=27)，另外一组患者接受了0.5 g/kg 20
% 甘露醇(甘露醇组，n=31)的降颅压治疗，两种药物均经深静脉在30 min 内快速滴注完成。用药期间，连续监测患者ICP，平均动
脉压(mean arterial pressure, MAP)、脑灌注压(cerebral perfusion pressure, CPP)及中心静脉压(central venous pressure, CVP)。记录有
效降颅压持续时间、ICP 最大降幅及其时间，用药前及用药后1 h、3 h、6 h抽血查电解质和血浆渗透压等。结果：静脉快速滴注7.5
%HTS和20 %甘露醇后，两者均可有效降低ICP(P<0.05)。两组在控制颅高压的有效率、起效时间及ICP降幅无统计学差异(P>0.
05)，但HTS组的作用持续时间要明显长于甘露醇组(P<0.05)。两组渗透压较用药前相比均有显著上升(P<0.05)。用药前后，两组
MAP、CPP和CVP 变化无统计学差异(P>0.05)。结论：等渗透剂量的7.5%HTS与20 %甘露醇均可有效降低患者的ICP，两者降
颅压效果相当，均可作为治疗颅内高压的一线治疗药物。 |
| 英文摘要: |
| Objective:To compare the effects of 7.5 %hypertonic saline and 20 %mannitol in doses of similar osmotic burden for
treating intracranial hypertension.Methods:A study was conducted with patients showing intracranial pressure (ICP) > 20 mmHg lasting
for 5 min. Patients were administered either 4 mL/kg 7.5 %hypertonic saline (HTS group, n = 27) or 0.5 g/kg 20 %mannitol (mannitol
group, n=31), intravenously from admission. Two agents were administered as a bolus via a central venous catheter, infused for over 30
min. Data collected fromeach eligible patient included ICP, plasma osmolarity, electrolytes, and potential adverse effects associated with
HTS and mannitol during administration.Results:Both agents were effective in achieving goal ICP (ICP < 20 mmHg) during infusion.
There were no statistical difference between both groups in the effective rate to control intracranial hypertension, biggest drop in ICP and
the mean duration of the effect (P>0.05). Plasma osmolarity in two groups increased significantly (P<0.05).Conclusion:Treatment with
7.5 % HTS and 20 % mannitol in doses of similar osmotic burden produces is effective and safe for ICP control. Both agents can be
recommended as first-line agents in management of raised ICP. |
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