Effect of different application timing of mannitol on hematoma control and prognosis in patients with acute cerebral hemorrhage
Objective To explore the effect of different application timing of mannitol on hematoma control and prognosis in patients with acute cerebral hemorrhage.Methods 130 patients with acute cerebral hemorrhage who received conservative treatment were divided into a control group(n=65)and an observation group(n=65)according to random number table method.Patients in the control group were given intravenous mannitol injection immediately after admission,while those in the observation group were given intravenous mannitol injection immediately or 6 h later according to specific CT results.Both groups were compared in terms of control of hematoma,treatment effect,serum nerve function index[S100 calcium-binding protein B(S100B),insulin-like growth factor-1(IGF-1),neuron-specific enolase(NSE)]levels and the occurrence of mannitol-related adverse reactions.Results After 2 d of treatment,the hematoma volume change of the observation group was better than that of the control group(Z=2.358,P<0.05),and the incidence of new bleeding of 1.54%was lower than 10.77%of the control group(χ2=4.795,P<0.05).After 2 weeks of treatment,the total effective rate of 100.00%in the observation group was higher than 90.77%in the control group(P<0.05).Immediately after admission,there was no significant difference in S100B,IGF-1 and NSE levels between the two groups(P>0.05).After 2 weeks of treatment,S100B and NSE levels in both groups were lower than those immediately after admission,and IGF-1 levels were higher than those immediately after admission;the observation group had S100B of(0.80±0.11)μg/L and NSE of(19.82±2.65)ng/ml,which were lower than(0.92±0.14)μg/L and(22.71±3.68)ng/ml in the control group;IGF-1 of(326.43±51.98)ng/ml in the observation group was higher than(278.19±45.21)ng/ml in the control group(P<0.05).During the treatment period,the incidence of mannitol-related adverse reactions in both groups was very low,and there was no statistical significance between the two groups(P>0.05).Conclusion Determining the timing of mannitol administration according to cranial CT results may be a more scientific way to reduce cranial pressure in acute cerebral hemorrhage,which is helpful to actively control hematoma and improve therapeutic effect,different timing of administration does not increase the occurrence of related adverse reactions.
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