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静脉输注甘露醇引起急性肾功能衰竭,国内报道甚少。我们见到4例,报道如下. 病例摘要例1 女,50岁。因头痛呕吐1天入院,高血压病史3年,血压200/100mmHg.嗜睡状,颈部有抵抗,左侧偏瘫,脑脊液为血性,尿常规、血钾,血尿素氮正常.诊断脑出血合并蛛网膜下腔出血。静脉输注20%甘露醇250ml,4小时1次,总剂量4000ml(800克).尿量减少,24小时尿量510～10ml～无尿。尿蛋白(++++)。镜检:红细胞、透明管型、颗粒、蜡样管型.尿素氮48.5mg%,血肌酐8.8mg%,停用甘露醇,给速尿等治疗无效死亡。例2 女,53岁.因头痛,意识不清,小便失禁入院。高血压病史7～8年。血压160/120mmH(?)
Mannitol intravenous infusion caused acute renal failure, few reports. We see 4 cases, reported as follows. Case summary 1 female, 50 years old. Due to headache and vomiting 1 day admission, history of hypertension 3 years, blood pressure 200 / 100mmHg. Drowsiness, neck resistance, left hemiplegia, cerebrospinal fluid is bloody, urinary routine, serum potassium, blood urea nitrogen normal. Subcapsular hemorrhage. Intravenous infusion of 20% mannitol 250ml, 4 hours 1, the total dose of 4000ml (800g.) Decreased urine output, urine output of 24 hours, 510 ~ 10ml ~ no urine. Urinary protein (++++). Microscopic examination: erythrocytes, transparent tube, granules, wax-like tube type.Urea nitrogen 48.5mg%, serum creatinine 8.8mg%, disable mannitol, to furosemide and other treatment died. Example 2 Female, age 53. Admitted to hospital due to headache, unconsciousness. Hypertensive history of 7 to 8 years. Blood pressure 160 / 120mmH (?)