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在重度顽固性肺心症右心衰时,加用甘露醇能明显地提高疗效,改善病情。 近年来 我院收治二十例重度心肺病右心衰病人,在常规抗感染、强心、利尿治疗效果不理想的情况下,加用20％的甘露醇250ml静点每日1～2次连用3～5天左右,病情均有明显好转,浮肿消退,心率减慢,缺氧状况改善,饮食增加,精神好转。 讨论 重度肺心症右心衰病人应用甘露醇,具有下列作用: 防治脑水肿:重度肺心症右心衰病人,因脑缺氧几乎都有脑水肿存在,应用甘露醇后迅速提高血浆渗透压,因甘露醇不易通过血脑屏障,使血管腔与脑组织间很快形成一个渗压梯度,脑组织内大量水份移入血管内,由肾小球滤过排出体外,从而降低颅内压。
In severe intractable pulmonary heart disease, right heart failure, plus mannitol can significantly improve the efficacy and improve the condition. In recent years, our hospital admitted 20 patients with severe cardiopulmonary right heart failure patients in the conventional anti-infective, cardiac, diuretic treatment is not ideal, plus 20% mannitol 250ml intravenous 1 or 2 times a day 3 to 5 days or so, the condition was significantly improved, edema subsided, heart rate slowed, hypoxia improved, diet increased, the spirit improved. Discussion of severe pulmonary heart disease patients with right heart failure, the application of mannitol, has the following effects: prevention and treatment of cerebral edema: severe pulmonary heart disease in patients with right heart failure due to cerebral ischemia almost all brain edema, the application of mannitol rapidly increased plasma osmolality Because mannitol is not easy to pass through the blood-brain barrier, an osmotic gradient is rapidly formed between the blood vessel cavity and the brain tissue. A large amount of water in the brain tissue moves into the blood vessel and is excreted by the glomerular filtration, thereby reducing intracranial pressure.