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[目的]探讨急性脑血管病患者治疗效果与早期肾功能衰竭防治的相关性。[方法]对急性脑血管病患者采用半量甘露醇分次与速尿交替给药治疗,并与全量甘露醇治疗的对照组进行疗效及早期肾功能衰竭指标比较。[结果]观察组中基本痊愈11例,显效10例,有效4例,总有效率达89.29%;对照组中基本痊愈13例,显效10例,有效3例,总有效率达92.86%。两组患者的总有效率无明显差异(P﹥0.05)。观察组的电解质紊乱和肾脏损害各项指标均明显低于对照组(P﹤0.05)。观察组的ARF发生率明显低于对照组(P﹤0.05)。[结论]治疗急性脑血管病所用的甘露醇对肾脏确有一定程度的毒性,可引起水电解质紊乱,且肾功能的损害程度与甘露醇每次的剂量、使用的频率和持续时间有关,提示临床上在治疗急性脑血管病使用甘露醇时应尽量减少剂量,适当延长间隔时间,缩短疗程,防止急性肾衰的发生和引起电解质紊乱。
[Objective] To investigate the correlation between the therapeutic effect of acute cerebrovascular disease and prevention and treatment of early renal failure. [Method] The patients with acute cerebrovascular disease were treated with alternating half mannitol and furosemide, and compared with the control group of total mannitol and the index of early renal failure. [Results] In the observation group, 11 cases were cured basically, 10 cases were markedly effective and 4 cases were effective. The total effective rate was 89.29%. In the control group, 13 cases were basically cured, 10 cases were markedly effective and 3 cases were effective. The total effective rate was 92.86%. There was no significant difference in the total effective rate between the two groups (P> 0.05). The electrolyte imbalance and renal damage in the observation group were significantly lower than those in the control group (P <0.05). The incidence of ARF in the observation group was significantly lower than that in the control group (P <0.05). [Conclusion] Mannitol used in the treatment of acute cerebrovascular disease does have certain degree of toxicity to the kidney, which can cause water and electrolyte imbalance. The degree of renal damage is related to the dosage of mannitol, the frequency and duration of use, suggesting that Clinical use of mannitol in the treatment of acute cerebrovascular disease should minimize the dose, the appropriate interval to extend and shorten the course of treatment to prevent the occurrence of acute renal failure and electrolyte imbalance.