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Systematic Review for Efficacy and Safety of HS and Mannitol in the Treatment of Intracranial Hyperension

Author: ShenXiaoWei
Tutor: WangHongQin
School: Shanxi Medical
Course: Neurosurgery
Keywords: Hypertonic saline Mannitol Cerebral edema Intracranial hypertension System Evaluation
CLC: R741
Type: Master's thesis
Year: 2011
Downloads: 53
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Abstract

Objective: To investigate hypertonic saline and mannitol safety and efficacy of the treatment of cerebral edema and intracranial hypertension . Method : follow the principles of evidence-based medicine , the Cochrane systematic review method , using a combination of computer searches and manual searches , literature database search from January 1995 to December 2010 , MEDLINE , EMBASE, the Cochrane Library , CNKI . Into hypertonic saline and mannitol treatment of intracranial hypertension randomized controlled trials (randomized controlled trials, RCT). By two evaluators jointly evaluating the quality of the included studies , met the inclusion criteria Meta-analysis was performed using Rev Man 4.2 software . Results: A total of 12 to meet the requirements of the RCT study , a total of 481 cases , including the number of cases . Are included in the study based on a random method , allocation concealment and blinding describe the three indicators of research quality score grading results are B grade . The 12 studies included both hypertonic saline and mannitol control after the merger Meta analysis showed that : ( 1) hypertonic saline and mannitol intracranial pressure ( intracranial pressure , ICP ) in the treatment of intracranial hypertension before and after intracranial perfusion pressure (cerebral perfusion of pressure changes in the CPP) and mean arterial blood pressure (mean arterial pressure, MAP) test P value of less than 0.05 , the results were statistically significant , the weighted mean difference (weighted mean difference, WMD) and 95 ? were 1.18 ( 0.68-1.67 ) 2.10 ( 0.33-3.87 ) 3.10 ( 1.33-4.87 ) . ( 2 ) the rest of the study due to the presence of a large heterogeneity , descriptive analysis after hypertonic saline is superior to mannitol , onset time, the time of maximum effect and maintain time will not reduce intracranial perfusion pressure , but does not increase the incidence of systemic side effects . Conclusion: (1) hypertonic saline to reduce the effect of intracranial pressure from lower intracranial pressure most significant , the maximum effect of time or to maintain the time better than mannitol reduce intracranial pressure than mannitol safer and more effective , and fewer complications . (2) hypertonic saline is a clinically available for selection of a dehydrating agent .

Systematic Review for Efficacy and Safety of HS and Mannitol in the Treatment of Intracranial Hyperension

Abstract

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