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目的 观察对早期高血压性脑出血患者采用甘露醇治疗对经颅多普勒 (transcranialDoppler,TCD)血流动力学参数的影响 ,并探讨正确使用甘露醇的方法。方法 4 0例高血压性脑出血患者随机分为观察组和对照组 ,使用TCD测定大脑中动脉平均血流速度 (bloodflowmeanvelocity,Vm)及脉动指数 (pulseindexes,PI) ,对实验前后参数的变化进行统计学分析。结果 治疗前 ,两组高血压性脑出血患者TCD测定Vm及PI值 ,差异无显著性 (P>0 0 5 ) ;治疗后 ,Vm值显示观察组减小 ,而对照组增加 ,二者比较差异有显著性 (P <0 0 5 ) ;PI值显示观察组增加 ,而对照组减小 ,二者比较差异有显著性 (P <0 0 5 )。结论 TCD血流动力学参数对脱水治疗有指导意义 ;早期发病的高血压少量脑出血患者慎用甘露醇脱水治疗 ,以免血肿扩大 ,加重病情
Objective To observe the effect of mannitol on the hemodynamics of transcranial doppler (TCD) in patients with early hypertensive intracerebral hemorrhage (ICH) and to explore the proper way to use mannitol. Methods 40 patients with hypertensive intracerebral hemorrhage were randomly divided into observation group and control group. The blood flowmeanvelocity (Vm) and pulseindexes (PI) of middle cerebral artery were measured by TCD. The changes of parameters before and after the experiment Statistical analysis. Results Before treatment, there was no significant difference in Vm and PI between two groups of patients with hypertensive intracerebral hemorrhage (P> 0.05). After treatment, Vm decreased in the observation group and increased in the control group The difference was significant (P <0 05); PI value showed that the observation group increased, while the control group decreased, the difference between the two was significant (P <0 05). Conclusions TCD hemodynamic parameters are instructive for dehydration therapy. Patients with early onset of small amount of hypertensive cerebral hemorrhage should be treated with mannitol dehydration carefully so as to avoid the enlargement of hematoma and aggravating of disease