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Journal of ZheJiang University(Medical Science)  2015, Vol. 44 Issue (4): 389-395    DOI: 10.3785/j.issn.1008-9292.2015.07.07
    
Comparison clinical efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage
HUANG Xue-cai, YANG Ling-ling
Department of Neurosurgery, Lishui Central Hospital, Lishui 323000, China
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Abstract  

Objective: To compare the efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage. Methods: An alternating treatment protocol was used to compare the efficacy of 160 mL 3% hypertonic saline solution (HSS) with 150 mL 20% mannitol for episodes of increased intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage. The dependent variables were the extent and duration of reduction of increased ICP after each event. Results: Both 3% HSS and 20% mannitol rapidly decreased the ICP in patients with aneurysmal subarachnoid hemorrhage (P <0.01). No difference between two medications in the extent of duration of ICP and reduction of action (P >0.05). Conclusion: 3% HSS should be considered as the first-line osmotic drug in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage.



Key wordsMannitol/administration &      dosage      Subarachnoid hemorrhage/therapy      Intracranial hypertension/drug therapy      Intracranial hypertension/complications      Saline solution, hypertonic/administration &      dosage      Drug therapy, combination      Treatment outcome      Random allocation     
Received: 09 April 2015     
CLC:  R743  
Cite this article:

HUANG Xue-cai, YANG Ling-ling. Comparison clinical efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage. Journal of ZheJiang University(Medical Science), 2015, 44(4): 389-395.

URL:

http://www.zjujournals.com/xueshu/med/10.3785/j.issn.1008-9292.2015.07.07     OR     http://www.zjujournals.com/xueshu/med/Y2015/V44/I4/389


高渗盐水和甘露醇在动脉瘤性蛛网膜下腔出血患者降低颅内压中的应用

目的:比较3%高渗盐水和20%甘露醇治疗重症动脉瘤性蛛网膜下腔出血所致颅内压增高的疗效.方法:25例动脉瘤性蛛网膜下腔出血患者出现颅内压增高事件时,随机交替接受等渗透剂量的160 mL 3%高渗盐水与150 mL 20%甘露醇进行降低颅内压治疗,连续监测患者颅内压、平均动脉压、脑灌注压及中心静脉压.记录有效降低颅内压持续时间、颅内压最大降幅及其时间,用药前及用药后1 h、3 h 血钠水平及血浆渗透压.结果:3%高渗盐水和20%甘露醇均可降低颅内压 (均P <0.01),两者的降低颅内压作用持续时间及颅内压降幅差异均无统计学意义(均P >0.05).患者脑灌注压较用药前均上升(均P <0.01),平均动脉压先上升后下降,但差异无统计学意义(P >0.05).患者中心静脉压稍有波动,但差异均无统计学意义(均P >0.05).20%甘露醇治疗后患者血钠下降,3%高渗盐水治疗后患者血钠值上升,变化均有统计学意义(均P <0.05).20%甘露醇及3%高渗盐水治疗后患者血浆渗透压均先上升后下降,变化均有统计学意义(均P <0.01).结论:3%高渗盐水可作为治疗动脉瘤性蛛网膜下腔出血所致颅内压增高患者的一线治疗药物.


关键词: 甘露醇/投药和剂量,  蛛网膜下腔出血/治疗,  颅内高压/药物疗法,  颅内高压/并发症,  盐水,高渗/投药和剂量,  药物疗法,联合,  治疗结果,  随机分配 
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