[1]彭 亮.地塞米松联合甘露醇治疗对急性重症脑血管病脑保护作用的临床观察[J].医学信息,2020,33(18):145-146,149.[doi:10.3969/j.issn.1006-1959.2020.18.048]
 PENG Liang.Clinical Observation of the Protective Effect of Dexamethasone Combined with Mannitol on the Cerebral Protection of Acute Severe Cerebrovascular Disease[J].Medical Information,2020,33(18):145-146,149.[doi:10.3969/j.issn.1006-1959.2020.18.048]
点击复制

地塞米松联合甘露醇治疗对急性重症脑血管病脑保护作用的临床观察()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年18期
页码:
145-146,149
栏目:
药物与临床
出版日期:
2020-09-15

文章信息/Info

Title:
Clinical Observation of the Protective Effect of Dexamethasone Combined with Mannitol on the Cerebral Protection of Acute Severe Cerebrovascular Disease
文章编号:
1006-1959(2020)18-0145-03
作者:
彭 亮
(东丽区医院神经外科,天津 300300)
Author(s):
PENG Liang
(Department of Neurosurgery,Dongli District Hospital,Tianjin 300300,China)
关键词:
地塞米松甘露醇急性重症脑血管病脑保护作用
Keywords:
DexamethasoneMannitolAcuteSevere cerebrovascular diseaseBrain protection
分类号:
R969.4
DOI:
10.3969/j.issn.1006-1959.2020.18.048
文献标志码:
A
摘要:
目的 观察地塞米松联合甘露醇应用于急性重症脑血管病脑保护作用。方法 选取2018年5月~2019年5月在我院诊治的98例急性重症脑血管病患者为研究对象,采用随机数字表法分为对照组和观察组,各49例。对照组采用甘露醇治疗,观察组在对照组基础上联合地塞米松治疗,比较两组患者颅内压(ICP)检测情况(正常、轻度、中度、重度)、ICP恢复正常时间段比例、格拉斯哥昏迷(GCS)评分情况、病死率以及并发症发生情况。结果 观察组颅内压轻度、中度、重度升高发生率与对照组比较,差异无统计学意义(P>0.05);观察组1~2 d、3~4 d患者ICP恢复正常发生率均高于对照组,5~6 d、7 d及以后发生率均低于对照组,差异有统计学意义(P<0.05);观察组GCS 评分3~8分发生率低于对照组,9~12分、13~14分发生率均高于对照组,差异有统计学意义(P<0.05);观察组病死率为12.24%,低于对照组的14.28%,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论 临床采用地塞米松联合甘露醇应用于急性重症脑血管病治疗可减轻颅内压升高程度,缩短ICP恢复时间,提高GCS评分,降低颅内压,具有显著的脑保护作用。同时不会增加并发症,影响病死率,具有显著的临床应用价值。
Abstract:
Objective To observe the protective effect of dexamethasone combined with mannitol in acute severe cerebrovascular disease.Methods A total of 98 patients with acute severe cerebrovascular disease diagnosed and treated in our hospital from May 2018 to May 2019 were selected as the research objects, and were divided into the control group and the observation group by random number table method, with 49 cases in each group. The control group was treated with mannitol, and the observation group was treated with dexamethasone on the basis of the control group. The intracranial pressure (ICP) detection status (normal, mild, moderate, severe) of the two groups of patients was compared, and the ratio of the time period when ICP returned to normal, Glasgow coma (GCS) score, case fatality rate and complications.Results Compared with the control group, the incidence of mild, moderate, and severe increases in intracranial pressure in the observation group was not statistically different (P>0.05); the incidence of ICP returned to normal in patients in the observation group on 1-2 d and 3-4 d Higher than the control group, the incidence rates of 5-6 d, 7 d and later were lower than those of the control group, the difference was statistically significant (P<0.05); the incidence of GCS scores of 3-8 points in the observation group was lower than that of the control group,the incidence rates of 9-12 points and 13-14 points were higher than those of the control group,the difference was statistically significant (P<0.05); the mortality rate of the observation group was 12.24%, which was lower than the control group’s 14.28%,the difference was not statistically significant (P>0.05); There was no statistically significant difference in the incidence of complications between the two groups (P>0.05).Conclusion The clinical application of dexamethasone combined with mannitol in the treatment of acute severe cerebrovascular disease could reduce the increase in intracranial pressure, shorten the recovery time of ICP, increase the GCS score, reduce intracranial pressure, and had a significant brain protection effect. At the same time, it would not increase complications and affect the mortality rate, and had significant clinical application value.

参考文献/References:

[1]马国胜,彭彩丽,张东,等.急性重症脑血管病死亡风险的多因素分析及预测[J].中华老年心脑血管病杂志,2013,5(5):540-541.[2]张跃武.颈动脉内推注甘露醇加地塞米松治疗脑出血疗效观察[J].中国现代药物应用,2014(9):120-121.[3]张翠云.甘露醇和地塞米松联合应用对老年急性脑血管疾病患者的脑保护作用[J].新乡医学院学报,2014,31(1):45-47.[4]郭晓红.急性重症脑血管病并多器官功能障碍综合征的临床特点分析[J].中国医药指南,2013,11(4):191-193.[5]李华德,颜国平.地塞米松联合甘露醇应用于急性重症脑血管病脑保护作用的临床研究[J].中国医学创新,2014,12(2):31-32.[6]朱桐.地塞米松和甘露醇合用对急性重症脑血管病脑保护作用的疗效分析[J].北方药学,2015,12(10):46-47.[7]涂春莲.地塞米松与甘露醇合用对急性重症脑血管病脑保护作用的临床观察[J].中国社区医师,2016(4):27-28.[8]蔡黎伟.评价地塞米松和甘露醇合用对急性重症脑血管病脑保护作用的疗效[J].中外医疗,2015(12):121-122.[9]张帆,冯骏,王涛.地塞米松与甘露醇对急性重症脑血管病脑保护作用观察[J].中国实用神经疾病杂志,2015(7):27-29.[10]晁永峰.地塞米松联合甘露醇对急性重症脑血管病患者的脑保护作用[J].临床医学,2018(7):113-114.

相似文献/References:

[1]王文迪,李小兵,刘光晶.N-乙酰半胱氨酸对烟雾吸入大鼠急性肺损伤的疗效观察[J].医学信息,2018,31(23):101.[doi:10.3969/j.issn.1006-1959.2018.23.027]
 WANG Wen-di,LI Xiao-bing,LIU Guang-jing.Experimental Study on the Therapeutic Effects of N-Acetylcysteine on Smoke Inhalation-induced Acute Lung Injury in Rats[J].Medical Information,2018,31(18):101.[doi:10.3969/j.issn.1006-1959.2018.23.027]
[2]赵宏玉,杨爱民.地塞米松对甲状腺切除术后自控镇痛恶心呕吐发生率的影响[J].医学信息,2018,31(24):101.[doi:10.3969/j.issn.1006-1959.2018.24.028]
 ZHAO Hong-yu,YANG Ai-min.Effect of Dexamethasone on the Incidence of Spontaneous Nausea and Vomiting after Thyroidectomy[J].Medical Information,2018,31(18):101.[doi:10.3969/j.issn.1006-1959.2018.24.028]
[3]艾 露.地塞米松联合庆大霉素在非哺乳期乳腺炎治疗中的应用[J].医学信息,2022,35(16):138.[doi:10.3969/j.issn.1006-1959.2022.16.035]
 AI Lu.Application of Dexamethasone Combined with Gentamicin in the Treatment of Non-lactating Mastitis[J].Medical Information,2022,35(18):138.[doi:10.3969/j.issn.1006-1959.2022.16.035]
[4]刘传志.小剂量秋水仙碱联合地塞米松对急性痛风性关节炎患者疼痛症状及不良反应的影响[J].医学信息,2022,35(17):126.[doi:10.3969/j.issn.1006-1959.2022.17.034]
 LIU Chuan-zhi.Effect of Low-dose colchicine Combined with Dexamethasone on Pain Symptoms and Adverse Reactions in Patients with Acute Gouty Arthritis[J].Medical Information,2022,35(18):126.[doi:10.3969/j.issn.1006-1959.2022.17.034]
[5]金 英.硼替佐米治疗老年多发性骨髓瘤的效果[J].医学信息,2020,33(06):146.[doi:10.3969/j.issn.1006-1959.2020.06.047]
 JIN Ying.Effect of Bortezomib in the Treatment of Elderly Multiple Myeloma[J].Medical Information,2020,33(18):146.[doi:10.3969/j.issn.1006-1959.2020.06.047]
[6]巴 琳,曾凡荣,郭忠宝.地塞米松联合切口阻滞和腹腔内局部麻醉对腹腔镜胆囊切除术后的镇痛效果[J].医学信息,2020,33(08):167.[doi:10.3969/j.issn.1006-1959.2020.08.056]
 BA Lin,ZENG Fan-rong,GUO Zhong-bao.Analgesic Effect of Dexamethasone Combined with Incision Block and Intraperitoneal Local Anesthesia After Laparoscopic Cholecystectomy[J].Medical Information,2020,33(18):167.[doi:10.3969/j.issn.1006-1959.2020.08.056]
[7]褚春沐.奥拉西坦联合甘露醇改善脑出血后脑水肿的效果观察[J].医学信息,2022,35(19):127.[doi:10.3969/j.issn.1006-1959.2022.19.036]
 CHU Chun-mu.Effect Observation of Oxiracetam Combined with Mannitol in Improving Cerebral Edema After Cerebral Hemorrhage[J].Medical Information,2022,35(18):127.[doi:10.3969/j.issn.1006-1959.2022.19.036]
[8]王启平,兰安宁,吴晓峰.低剂量地塞米松对乳腺癌化疗不良反应的影响[J].医学信息,2020,33(14):146.[doi:10.3969/j.issn.1006-1959.2020.14.045]
 WANG Qi-ping,LAN An-ning,WU Xiao-feng.Effect of Low-dose Dexamethasone on Adverse Reactions of Chemotherapy in Breast Cancer[J].Medical Information,2020,33(18):146.[doi:10.3969/j.issn.1006-1959.2020.14.045]
[9]彭 亮.甘露醇治疗早期脑出血对血肿扩大及预后的影响[J].医学信息,2020,33(17):155.[doi:10.3969/j.issn.1006-1959.2020.17.046]
 PENG Liang.The Effect of Mannitol Treatment of Early Cerebral Hemorrhage on Hematoma Enlargement and Prognosis[J].Medical Information,2020,33(18):155.[doi:10.3969/j.issn.1006-1959.2020.17.046]
[10]吴 强.地塞米松在早期急诊中暑患者的应用效果[J].医学信息,2020,33(22):156.[doi:10.3969/j.issn.1006-1959.2020.22.045]
 WU Qiang.Application Effect of Dexamethasone in Early Emergency Patients with Heatstroke[J].Medical Information,2020,33(18):156.[doi:10.3969/j.issn.1006-1959.2020.22.045]

更新日期/Last Update: 1900-01-01