甘露醇是甘露糖的还原物,是一种较为理想的利尿剂。应用甘露醇后能引起肾脏什么性质的改变,报道甚少。我们见到3例过量使用甘露醇液的尸检资料,现报告如下: 一、病例介绍 例1 王某,女,57岁。慢性胆囊炎急性发作。在硬脊膜外麻醉下手术。由于麻醉意外,术中心跳和呼吸骤停。抢救约10分钟后心跳恢复,118分钟后呼吸恢复。血压维持正常,但患者一直昏迷和四肢抽搐。为了防止脑水肿,于术后24小时用20％甘露醇液静脉注射。38小时内共注射4次,550ml。用药前,24小时尿量在1500～2 000ml,术后第三天尿量减少,第四天死亡(两天尿量共260ml)。血钾3.2～3.8mEq/L,临床无其他缺钾证据。 例2 万某,男,21岁。慢性胆囊炎急性坏疽性发作,胆总管结石嵌顿伴中毒性休克。术前及术中低 Mannitol is mannitol reduction, is a more ideal diuretic. The application of mannitol can cause changes in the nature of the kidney, little is reported. We have seen three cases of overdose of mannitol autopsy data are reported as follows: First, case introduction Example 1 Wang, female, 57 years old. Chronic cholecystitis acute attack. Surgery under epidural anesthesia. Due to anesthesia accidents, intraoperative jump and respiratory arrest. Rescue heartbeat recovery after about 10 minutes, resuscitation after 118 minutes. Blood pressure remained normal, but patients had been unconscious and convulsions in their limbs. In order to prevent cerebral edema, 24 hours after surgery with 20% mannitol intravenously. Total injection within 38 hours 4 times, 550ml. Before treatment, 24-hour urine output in 1500 ~ 2 000 ml, urine output decreased the third day after the operation, the fourth day of death (a total of two days of urine output 260 ml). Potassium potassium 3.2 ~ 3.8mEq / L, clinical evidence of other potassium deficiency. Example 2 million, male, 21 years old. Chronic cholecystitis acute gangrenous attack, common bile duct stones with toxic shock. Preoperative and intraoperative low