Influence of different dosage of mannitol on hemodynamics after hypertensive intracerebral hemorrhage / 中国医师进修杂志

ABSTRACT

Objective To observe the influence of different dosage of mannitol on hemodynamics after hypertensive intracerebral hemorrhage ( HIH ). Methods Sixty cases with HIH were divided into three groups by random digits table with 20 cases each. Performing routine treatment, also 20% mannitol 250 ml was used 3-4 times/d for 14-21 d in group A,20% mannitol 125 ml was used 2-3 times/d for 3-14 d in group B,and mannitol was not used in group C. The mean blood flow velocity(Vm) and pulsatility index (PI)in bleeding side of the middle cerebral artery (M1) were measured by TCD, and monitoring patient's kidney function. Results After treatment 1 d , Vm comparative differences among three groups were no statistically significant (P ＞ 0.05 ), and after treatment 10 d and 3 weeks, the Vm in group A [(45.01 ± 5.13 ), (59.41 ±7.24) cm/s] and group B [(44.61 ± 5.04), (58.94 ±7.12) cm/s] were significantly higher than those in group C [(42.42 ±4.26), (55.06 ±7.16) cm/s] (P ＜0.05), but the differences were no statistically significant between group A and group B (P ＞0.05). With the extension of treatment time, PI recovery gradually, but compared PI,after treatment 1 d, 10 d and 3 weeks,there were no statistical differences among three groups (P ＞ 0.05 ). After treatment 3 weeks, kidney function abnormal ratio in group A [35.0%(7/20)] was significantly higher than that in group B [20.0% (4/20)] and group C [15.0% (3/20)] (P＜0.05). Conclusion Using small dosage of mannitol,not only increase HIH cerebral blood flow velocity,improve brain blood perfusion,reduce cerebral ischemic injury,but also reduce kidney damage,safety is higher.