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目的：探讨甘露醇联合盐酸法舒地尔治疗颅脑术后脑水肿的疗效及对肿瘤坏死因子α（ TNF－α）水平和神经功能的影响。方法选取2014年3月至2015年3月咸阳市中心医院收治的颅脑术后脑水肿患者90例，依据抽签法将患者分成联合治疗组与甘露醇组，每组45例。联合治疗组在基础治疗的基础上采用甘露醇联合盐酸法舒地尔治疗，甘露醇组在基础治疗的基础上采用甘露醇治疗。观察比较两组患者脑部血流、水肿范围、TNF－α水平变化、神经功能缺损评分、疗效以及不良反应发生情况。结果治疗前后两组患者的水肿范围和 TNF－α水平在组间、时间点以及组间?时间点比较差异有统计学意义[（9．5±0．9） cm3、（5．6±0．4） cm3、（2．2±0．3） cm3比（9．5±0．8） cm3、（6．8±0．5） cm3、（3．3±0．3） cm3，（25．4±2．2）μg／L、（18．8±1．2）μg／L、（12．4±1．6）μg／L 比（25．4±2．2）μg／L、（20．5±1．1）μg／L、（14．2±1．6）μg／L，P＞0．05]，随治疗后时间的延长，两组患者的水肿范围均逐渐缩小，TNF－α水平逐渐降低，且联合治疗组较甘露醇组水肿范围更小，TNF－α水平更低；治疗1周后，联合治疗组大脑中动脉、大脑前动脉以及大脑后动脉平均血流速度高于甘露醇组[（43．3±3．1） cm／s 比（41．6±3．2） cm／s、（44．4±3．5） cm／s 比（42．2±3．4） cm／s、（42．4±2．4） cm／s比（39．6±2．6） cm／s]，差异有统计学意义（P＜0．05）；联合治疗组患者的神经功能缺损评分优于甘露醇组，差异有统计学意义（ P＜0．05）；联合治疗组患者治疗的有效率高于甘露醇组[97．78％（44／45）比86．67％（39／45）]，差异有统计学意义（P＜0．05），两组的临床疗效比较，差异也有统计学意义（ P＜0．05）；联合治疗组与甘露醇组的不良反应发生率比较差异无统计学意义[24．44％（11／45）比17．78％（8／45），P＞0．05]。结论甘露醇联合盐酸法舒地尔治疗能够有效改善颅脑术后脑水肿，降低患者神经功能缺损评分与TNF－α水平，增加患者大脑动脉的血流速度，促进患者恢复。“,”Objective To investigate the effect of mannitol combined with fasudil hydrochloride on treatment of postoperative cerebral edema and tumor necrosis factors ( TNF-α) levels and nerve function. Methods Ninety patients of brain cerebral edema in Central Hospital of Xianyang from Mar.2014 to Mar. 2015 were included in the study,and divided into a combined treatment group and a mannitol group by draw-ing lots method,45 cases in each group.The combined treatment group was given mannitol and fasudil hydro-chloride treatment plus the basic treatment ,and the mannitol group adopted mannitol treatment plus the basic method.The brain blood flow,edema range,TNF-αlevels,neurologic impairment scores,efficacy and adverse reactions of the two groups were observed and compared.Re sults The edema scope and TNF-αlevels of the two groups between groups, time points and groups? time points were statistically significantly different [(9.5 ±0.9) cm3,(5.6 ±0.4) cm3,(2.2 ±0.3) cm3 vs (9.5 ±0.8) cm3,(6.8 ±0.5) cm3,(3.3 ± 0.3) cm3 and (25.5 ±2.2) μg/L,(18.8 ±1.2) μg/L,(12.4 ±1.6) μg/L vs (25.4 ±2.2) μg/L, (20.5 ±1.1) μg/L,(14.2 ±1.6) μg/L,P<0.05].With the post-treatment time prolonging,the edema ranges of the two groups were shrinking,TNF-αwas gradually reduced,and the edema range and TNF-αlevel of the combined treatment group were better than the mannitol group.One week after treatment,the middle cerebral artery blood,anterior cerebral artery and posterior cerebral artery mean flow velocity of the combined treatment group were higher than the mannitol group[(43.3 ±3.1) cm/s vs (42.0 ±3.2) cm/s,(44.4 ± 3.5) cm/s vs (42.2 ±3.4) cm/s,(42.4 ±2.4) cm/s vs (39.6 ±2.6) cm/s,P<0.05) .One week after treatment,the neurologic impairment score of the combined treatment group was better than the mannitol group,the difference was statistically significant ( P <0.05 ) .The effective rate of the combined treatment group was better than the mannitol group[97.78%(44/45) vs 86.67%(39/45)],the difference was statis-tically significant(P<0.05),the clinical efficacy of the combined treatment group was better than the man-nitol group(P0.05].Conclusion Mannitol combined with fasudil hydro-chloride can effectively improve the postoperative cerebral edema , reduce neurologic impairment scores and TNF-αlevels,increase cerebral artery blood flow velocity,and promote the patient recovery.