兰涛

【摘要】目的：探析甘露醇用于急性脑梗死的临床效果，为临床工作者提供参考。方法：回顾分析自2013年12月至2014年12月期间，我院收治的70例急性脑梗死患者的临床资料。按数字随机表法将患者分为观察组和对照组，给予所有患者肝素抗凝血、阿司匹林抗血小板凝集、依达拉奉清除自由基和血管扩张等常规治疗。在常规治疗的基础上给予观察组患者（n = 35）甘露醇脱水，剂量根据患者的平均动脉压均调整；给予对照组患者（n = 35）甘露醇脱水，剂量为125 ml/次，每日2次。结果：观察组患者治疗显效12例，治疗有效20例，治疗无效3例，治疗有效率为91.43%；对照组患者治疗显效9例，治疗有效16例，治疗无效10例，治疗有效率为71.43%，治疗效果在组间具有显著性差异（P < 0.05）。结论：甘露醇能有效降脱水低颅内压，利尿改善微循环，应该根据患者的病情合理调整用药剂量。

【关键词】甘露醇；急性脑梗死；脱水；微循环；抗凝

【Abstract】Objective： To probe into the clinical effect of mannitol for acute cerebral infarction， and provide reference for clinical workers. Methods： retrospective analysis from 2013 December to 2014 December period， the clinical data of 70 cases of acute cerebral infarction patients in our hospital.According to the random number table method the patients were divided intoobservation group and control group， all the patients were given heparinanticoagulant， free radicals and dilation of blood vessels and other conventional treatment of aspirin antiplatelet， edaravone clearance. The patients in the observation group were given based on routine treatment （n = 35） with mannitol，dose according to the patients with mean arterial pressure are adjusted； to give the patients in the control group （n = 35） of mannitol， the dosage was 125 ml/， 2 times a day. Results： To observe the therapeutic effect of 12 cases patients，treatment was effective in 20 cases， the treatment of 3 cases were invalid， the effective rate of treatment was 91.43%； the control 9 cases patients in the treatment group， treatment was effective in 16 patients， the treatment of 10 cases ineffective， the effective rate of treatment was 71.43%， with significant differencein treatment effect between the groups （P < 0.05）. Conclusion： mannitoldehydration can effectively reduce low intracranial pressure， diuresis， improve microcirculation， we should reasonably adjust the dosage according to the patient's condition.

【key words 】mannitol； acute cerebral infarction； dehydration； microcirculation；anticoagulation

【中圖分类号】R722.12 【文献标识码】B【文章编号】1004-4949（2015）02-0013-02

急性脑梗死好发于中老年人，50岁以上人群发病率高达51.35%[1]，并且具有季节性，好发于冬季，缺乏近年有关急性脑梗死的流行病学调查，但近几年急性脑梗死患者呈逐年增加趋势。虽然急性脑梗死的症状轻微，但是大多患者年老体弱，并发症多，发病会很迅速，而且约50%的患者留下明显的后遗症。脑水肿是脑梗死常见的继发性损害[2]，而脱水治疗是减轻脑水肿的重要措施之一。

1 资料与方法

1.1 基本资料

回顾分析自2013年12月至2014年12月期间，我院收治的70例急性脑梗死患者的临床资料。按数字随机表法将患者分为观察组和对照组，观察组患者（n = 35）年龄分布44～74岁，平均年龄为58.83 ± 3.61岁；……