Node Y, Yajima K, Nakazawa S
No To Shinkei. 1983 Dec;35(12):1241-6.
A rebound phenomenon after infusion of hypertonic solution of mannitol and glycerol on raised intracranial pressure was studied by epidural pressure recordings for 65 patients. The mean age of the patients was 50 years with a range of 29 to 73 years. The diagnoses of above patients were as follows; 29 were cerebral aneurysms, 19 were brain tumors, 10 were hypertensive intracerebral hemorrhages, 4 were cerebral contusions, 2 were arteriovenous malformations, and one was cerebral abscess. Four methods of infusion were performed. In group A, 0.5 g/kg of mannitol was infused within 15, 30 or 60 minutes. In group B, 1.0 g/kg of mannitol was infused within 30, 60 or 90 minutes. In group C, 0.5 g/kg of glycerol in 5% fructose was infused within 30, 60 or 90 minutes. In group D, 1.0 g/kg of glycerol in 5% fructose was infused within 60, 120 or 180 minutes. The following observations were examined in all patients. (1) The occurrence of the rebound phenomenon. (2) The rate of the raised intracranial pressure (ICP) compared to the ICP before infusion of these hypertonic solutions. (3) The duration of the rebound phenomenon.
A rebound phenomenon was found 23% in all patients, and 12% in the mannitol groups and 34% in the glycerol groups. The dose and the rate of mannitol infusion did not influence the occurrence of the rebound phenomenon. In contrast, in the glycerol groups, the infusion method did influence the occurrence of the rebound phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)
通过对65例患者进行硬膜外压力记录,研究了输注甘露醇和甘油高渗溶液后颅内压升高的反弹现象。患者的平均年龄为50岁,范围在29至73岁之间。上述患者的诊断如下:29例为脑动脉瘤,19例为脑肿瘤,10例为高血压性脑出血,4例为脑挫伤,2例为动静脉畸形,1例为脑脓肿。进行了四种输注方法。A组在15、30或60分钟内输注0.5 g/kg甘露醇。B组在30、60或90分钟内输注1.0 g/kg甘露醇。C组在30、60或90分钟内输注5%果糖中含0.5 g/kg甘油。D组在60、120或180分钟内输注5%果糖中含1.0 g/kg甘油。对所有患者检查了以下观察指标。(1)反弹现象的发生情况。(2)与输注这些高渗溶液前的颅内压相比,颅内压升高的速率。(3)反弹现象的持续时间。
在所有患者中发现23%出现反弹现象,甘露醇组为12%,甘油组为34%。甘露醇的输注剂量和速率不影响反弹现象的发生。相比之下,在甘油组中,输注方法确实影响反弹现象的发生。(摘要截断于250字)