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甘露醇广泛应用于降低各种原因引起的颅内压升高和利尿等.根据脱水原理,甘露醇常常用于眼科各种类型的青光眼患者,它降眼压速度快,不良反应小,尤其对急性闭角型青光眼,当其他降眼压药物不能降低眼压时,甘露醇快速iv gtt降眼压效果较佳.甘露醇还常用于各种眼内手术前或手术中.其目的是使眼压下降,玻璃体浓缩,以避免手术中出现眼内容物脱出.作者于1994年5月为1例既患青光眼又是白内障的患者施行青光眼小梁切除和晶状体摘出手术.手术前30min用20%甘露醇250ml iv gtt(30min内滴完).手术开始15min,患者出现呼吸困难.脉搏细弱快,HR140beats/min,BP11.97/7.98kPa(90/60mmHg),出现急性左心衰竭症状态,手术马上停止,并请心脏科医师来抢救,立即iv西地兰加0.4mg 加25%GS20ml.患者采取半卧位.用药数分数后症状缓解,1h后患者情况良好,在心电监护下继续进行手术,手术相当顺利.由于抢救及时未酿成悲剧.
Mannitol is widely used to reduce various causes of increased intracranial pressure and diuretic, etc. According to the principle of dehydration, mannitol is often used in various types of patients with glaucoma ophthalmic eye drops it fast, adverse reactions, especially for Acute angle-closure glaucoma, when other intraocular pressure drugs can not reduce intraocular pressure, mannitol iv iv tonic intraocular pressure is better. Mannitol is also commonly used in various intraocular surgery before surgery or its purpose is to make the eye Pressure drop and vitreous body concentration to prevent the intraoperative ocular contents from escaping.The author performed a glaucoma trabeculectomy and lens extraction surgery in 1 patient with both glaucoma and cataract in May 1994. Thirty minutes before the operation, Alcohol 250ml iv gtt (drip finished in 30min) .After 15 minutes of operation, the patient had dyspnea.Pulse weak and fast, HR140beats / min, BP11.97 / 7.98kPa (90 / 60mmHg), acute left ventricular failure state, Stop and ask a cardiologist to rescue, immediately iv cilantro plus 0.4mg plus 25% GS20ml. The patient took a semi-recumbent position after the number of drugs to relieve symptoms, 1h after the patient was in good condition, under the ECG to continue the operation, The operation is quite smooth Not in time to save the tragedies.