尼莫地平治疗外伤性蛛网膜下腔出血后脑血管痉挛的疗效观察

    Effects of nimodiping on delayed cerebral vasospasm after traumatic subarachnoid hemorrhage

    • 摘要: 目的:观察尼莫地平对治疗外伤性蛛网膜下腔出血(tSAH)后脑血管痉挛的疗效。方法:80例tSAH患者随机分为对照组和尼莫地平组各40例。均进行常规降颅压、止血、营养神经等治疗,尼莫地平组在常规治疗基础上加用尼莫地平1 mg/h微量泵入,2周后改为尼莫地平片剂30 mg,每天3次持续使用12~24周。并于治疗后24 h和72 h、7 d和14 d应用经颅多普勒观察伤后大脑中动脉血流动力学变化及3个月后哥拉斯哥昏迷预后评分。结果:尼莫地平组脑血管痉挛程度及预后与对照组差异有统计学意义(P<0.05)。结论:尼莫地平对tSAH后脑血管痉挛的防治效果明显,并改善患者预后。

       

      Abstract: Objective:To investigate the clinical efficacy and safety of nimodiping on delayed cerebral vasospasm after traumatic subarachnoid hemorrhage(tSAH). Methods:Eighty patients with tSAH were randomly divided into nimodiping treatment group and control group. While the routine treatments of decreasing intracranial pressure,stopping bleeding,nutrition for nerve and so on,were used in two groups, the nimodiping was added through intravenous administration (1 mg/h) in treatment group. Two weeks later, nimodiping were continuously used through oral administration (30 mg tid) for 12-24 weeks. And then, the examination of color doppler were performed to observe hemodynamic changes of the middle cerebral artery at 24 hours,72 hours,the seventh,fourteenth day. Glasgow outcome scale after three months of the treatments was observed and analysed. Results:The levels of cerebral vasospasm and prognosis were significant difference between nimodiping treatment group and control group(P<0.05). Conclusions:Nimodiping can obviously prevent cerebral vasospasm and improve outcome of patient's after tSAH.

       

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