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The Effect of Mannitol Application at Different Times on the Prognosis of Patients with Cerebral Hemorrhage and an Analysis of Related Factors |
LIU Xiaofei , FANG Chenguang , NI Junxi |
Chizhou People's Hospital, Anhui Chizhou 247100, China |
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Abstract Objective: To explore the influence of mannitol application at different times on the prognosis of patients with cerebral hemorrhage and to analyze the related factors. Methods: The clinical data of 80 patients with primary cerebral hemorrhage admitted between January 2017 and December 2020 were retrospectively analyzed. Among them, 40 patients were treated with mannitol 6 hours before admission and were included in group A, and 40 patients who were treated with mannitol 6 hours after admission were included to group B. The prognoses of the two groups of patients were compared before they were divided into a good prognosis group (58 cases) and a poor prognosis group (22 cases). Univariate analysis and multivariate logistic regression were used to analyze the prognostic factors of patients with cerebral hemorrhage. Results: The prognosis of patients in group B was better than that in group A, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that advanced age, long time from onset to admission, high NIHSS score at admission, high GLU level, and bleeding volume were mostly independent risk factors for poor prognosis in patients with cerebral hemorrhage (P<0.05), while GCS score at admission was high. CT image showed that the midline did not shift, did not break into the ventricle, and the application of mannitol 6 hours after admission was an independent protective factor for the good prognosis of patients with cerebral hemorrhage (P<0.05). Conclusion: Patients with cerebral hemorrhage treated with mannitol 6 hours after admission can get a better prognosis, and age, onset to admission, GCS score, NIHSS score, blood sugar, bleeding volume, midline structure shift, break into the ventricle, and mannitol application timing are related to the prognosis of patients with cerebral hemorrhage. In clinical treatment, timely and effective treatment should be carried out according to the above related factors to improve the prognosis of patients.
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[1] 赵燕民,洪丽,王献,等.自发性脑出血患者血清降钙素原、淀粉样蛋白A及和肽素动态检测[J].郑州大学学报(医学版),2018,53(2):188~192. [2] 任莉.甘露醇应用时机对中等量脑出血临床治疗效果的影响[J].中国基层医药,2018,25(16):2136~2138. [3] 符雄,王鹏,包文娟,等.海南陵水黎族自治县高龄自发性脑出血患者的预后生存分析[J].河北医科大学学报,2018,39(8):898~902. [4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2019)[J].中华神经科杂志,2019,52(12):994~1005. [5] Wiesmann M,Steinmeier E,Magerkurth O,et al.Outcome prediction in traumatic brain injury:comparison of neurological status,CT findings,and blood levels of S140B and GFAP[J].Acta Neurol Scand,2010,121(3):178~185. [6] 张成刚.脑出血昏迷病人继发多器官功能障碍综合征的危险因素分析[J].蚌埠医学院学报,2017,42(6):736~737. [7] 袁璞珺.CT辅助甘露醇不同应用时机对急性脑出血患者血肿扩大、脑水肿、血清AQP4及预后的影响[J].中国CT和MRI杂志,2018,16(4):43~46. [8] 孙博,周其辉.七叶皂苷钠联合甘露醇治疗脑出血53例[J].西部中医药,2017,30(4):97~99. [9] 张运,王莉莉,唐涛,等.甘露醇不同时间给药联合醒脑静对实验性脑出血大鼠灶周水肿的影响[J].中风与神经疾病杂志,2018,35(10):6~10. [10] Zhang WL,Neal J,Lin L,et al.Mannitol in critical care and surgery over 50+ years:a systematic review of randomized controlled trials and complications with meta-analysis[J].Neurosurg Anesthesiol,2019,31(3):273~284. [11] 杨庆晓,关文明,宋彬,等.急性脑出血患者血清ICAM-1,cFN水平与炎性因子相关性及预后的危险因素分析[J].疑难病杂志,2019,18(6):549~553,558. [12] 李庆勇,林茹,张东明,等.影响自发性脑出血患者预后的相关因素分析[J].中华保健医学杂志,2019,21(6):525~527. |
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