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目的 :探讨治疗重症脑水肿患者在不减低甘露醇剂量以保持疗效的前提下 ,防止甘露醇性急性肾功能衰竭 (ARF)的有效方法。方法 :选择格拉斯哥昏迷计分法 (GCS)≤ 8分的重症脑水肿患者 ,常规应用甘露醇作为主要脱水剂 ,A组 4 0例 ,在应用甘露醇的同时应用呋塞米 (速尿 ) ,剂量为2 0mg ,每 12h 1次。B组 38例 ,用甘露醇时不用速尿。监测两组患者血肌酐、尿素氮、尿常规、血电解质等 ,记录患者转归。结果 :共发生甘露醇性ARF15例 ,其中A组 2例 ,B组 13例 ,经统计学处理两组有显著性差异。两组肾功能异常者发生率均较高 ,对照无差异 ,但发展至ARF的比率B组明显高于A组 ,有显著性差异。结论 :在应用甘露醇同时应用速尿对甘露醇所致肾功能损害确有预防保护作用
Objective: To explore effective ways to prevent mannitol-induced acute renal failure (ARF) in patients with severe cerebral edema without reducing the dosage of mannitol to maintain the therapeutic effect. Methods: Patients with severe brain edema who had a GCS ≤ 8 were enrolled in this study. Mannitol was routinely used as the main dehydrating agent in group A, 40 patients in group A were treated with furosemide (furosemide) The dose of 20mg, every 12h 1 time. Group B, 38 cases, with mannitol without furosemide. Monitoring two groups of patients serum creatinine, urea nitrogen, urine, blood electrolytes, etc., record the patient outcome. Results: A total of 15 cases of mannitol ARF occurred, including 2 cases in group A and 13 cases in group B, which were statistically different between the two groups. The incidence of renal dysfunction in the two groups were higher, no difference in the control, but the rate of development to ARF in group B was significantly higher than that in group A, with significant differences. CONCLUSIONS: Mannitol administered in combination with furosemide had a protective and preventive effect on mannitol-induced renal impairment