摘要
目的观察高渗盐水治疗恶性大脑中动脉(MMCA)脑梗死(MMCAI)的有效性及安全性。方法回顾性分析内科治疗的MMCAI患者26例,在基础治疗上给予20%甘露醇16例(甘露醇组)、10%氯化钠溶液10例(HS组),收集两组的基本临床资料,记录生命体征及实验室监测指标,计算Δ出入量(入量-出量),记录相关不良反应及发病30 d、3个月后的生存状态。结果两组基本临床资料比较,P均>0.05;两组血WBC、Hb、BUN、Cr、电解质、血气分析、每日Δ出入量比较,P均>0.05;HS组血钠及血浆渗透压(OSM)高于甘露醇组(P均<0.05),但血钠在治疗目标范围内;甘露醇组和HS组分别有6、4例出现肾功能不全(P>0.05),均未观察到心律失常、急性左心衰竭、溶血等不良反应。甘露醇组和HS组发病30 d时分别死亡10、6例,3个月时死亡12、8例,P均>0.05。结论高渗盐水用于治疗MMCAI患者安全、有效。
Objective To evaluate the efficacy and safety of hypertonic saline in treatment of malignant middle cerebral artery infarction（ MMCAI）. Methods Twenty-six medical treated patients with MMCA I were retrospective studied,of whom 16 cases were treated with 20% mannitol（ mannitol group）,and the other 10 cases were treated with 10% hypertonic saline（ HS group）. The basic clinical data was collected,vital signs and laboratory results were recorded,intake and output volume changes were calculated,and the occurrence of adverse reaction and survival status at 30 d and 3 months were recorded. Results There were no differences in clinical data and WBC,Hb,BUN,Cr,electrolytes,blood gas analysis,changes of daily intake and output between the two groups（ all P〈 0. 05）. The serum sodium and plasma osmolality（ OSM） level was higher in the HS group than in the mannitol group（ all P〈 0.05）,but the serum sodium level was in the target range. There were 6 and 4 cases of renal insufficiency in the mannitol and HS group,respectively（ P〈 0. 05）,but arrhythmia,acute heart failure,hemolysis and other adverse reactions were not observed in the two group. There were 10and 6 cases of death at the 30th d,12 and 8 cases of death at 3 months,respectively（ all P〈 0. 05）. Conclusion Hypertonic saline is effective and safe in treatment of MMCA infarction.
出处
《山东医药》
CAS
2014年第24期10-12,共3页
Shandong Medical Journal
基金
国家自然科学基金资助项目(81271309)
北京市卫生系统高层次卫生技术人才培养计划项目(2009-3-09)
关键词
脑血管疾病
脑梗死
大脑中动脉
高渗盐水
甘露醇
cerebrovascular diseases
cerebral infarction
middle cerebral artery
hypertonic saline
mannitol
