尼莫地平联合法舒地尔辅助早期高压氧对脑动脉瘤栓塞术后脑血管痉挛患者相关指标的影响

发布时间：2019-05-12 03:41

【摘要】：目的:探讨尼莫地平联合法舒地尔辅助早期高压氧对脑动脉瘤栓塞术后脑血管痉挛患者相关指标的影响。方法:150例脑动脉瘤栓塞术后脑血管痉挛患者随机分为对照组(75例)和观察组(75例)。两组患者均给予早期高压氧治疗,每日1次,7 d为1个疗程,共3个疗程。在此基础上,对照组患者给予尼莫地平注射液10 mg,加入0.9%氯化钠注射液100 ml中,微泵持续输注,q8 h。观察组患者在对照组治疗的基础上加用盐酸法舒地尔注射液30 mg,加入5%葡萄糖注射液40 ml中,微泵持续输注,q8 h。两组疗程均为3周。观察两组患者治疗前后格拉斯哥(Glasgow)昏迷评分、大脑中动脉(MCA)平均血流速度、神经功能缺损(NFI)评分、巴氏(Barthel)指数评分、格拉斯哥预后量表(GOS)分级情况、术后30 d脑梗死发生情况及不良反应发生情况。结果:治疗后,两组患者Glasgow昏迷评分、MCA平均血流速度、Barthel指数评分均显著高于同组治疗前,且观察组高于对照组,NFI评分显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P0.05)。术后,观察组患者GOS各级例数均显著优于对照组,脑梗死发生率显著低于对照组,差异均有统计学意义(P0.05)。两组患者不良反应发生率比较差异无统计学意义(P0.05)。结论:尼莫地平联合法舒地尔辅助早期高压氧用于脑动脉瘤栓塞术后脑血管痉挛,可有效促进神经功能恢复,加快脑动脉血流速度,提高患者生存质量,且不增加不良反应的发生。
[Abstract]:Objective: to investigate the effect of nimodipine combined with fasudil combined with early hyperbaric oxygen on cerebral vasospasm after cerebral aneurysm embolism. Methods: 150 patients with cerebral vasospasm after cerebral aneurysm embolism were randomly divided into control group (75 cases) and observation group (75 cases). The patients in both groups were treated with early hyperbaric oxygen once a day and 7 days as a course of treatment for a total of 3 courses. On this basis, the patients in the control group were given nimodipine injection 10 mg, and 0.9% sodium chloride injection 100 ml, and the micropump was continuously infused for 8 h. On the basis of treatment in the control group, the patients in the observation group were treated with fasudil hydrochloric acid injection 30 mg, and 5% glucose injection 40 ml, and the patients in the observation group were continuously infused with micropump for 8 h. The course of treatment in both groups was 3 weeks. The Glasgow (Glasgow) coma score, the mean (MCA) blood flow velocity of middle cerebral artery, the (NFI) score of neurological deficit, the Pap (Barthel) index score and the (GOS) grade of Glasgow preemptive scale were observed before and after treatment. The occurrence of cerebral infarction and adverse reactions occurred 30 days after operation. Results: after treatment, the Glasgow coma score, MCA mean blood flow velocity and Barthel index score of the two groups were significantly higher than those of the same group before treatment, and the NFI score of the observation group was significantly higher than that of the control group, and the NFI score of the observation group was significantly lower than that of the control group. The difference was statistically significant (P 0.05). After operation, the number of GOS patients in the observation group was significantly better than that in the control group, and the incidence of cerebral infarction was significantly lower than that in the control group (P 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion: nimodipine combined with fasudil combined with early hyperbaric oxygen can effectively promote the recovery of nerve function, accelerate the blood flow velocity of cerebral artery and improve the quality of life of patients after cerebral aneurysm embolism. And does not increase the occurrence of adverse reactions.
【作者单位】：海南省人民医院神经外科;海南省人民医院TCD科;
【分类号】：R651.1+2

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