摘要
目的探讨经导引导管持续注入尼莫地平治疗颅内动脉瘤栓塞术并发脑血管痉挛(CVS)的疗效。方法行颅内动脉瘤栓塞术并发CVS的蛛网膜下腔出血患者60例,随机分为对照组和观察组,每组30例。两组均给予扩充血容量、升高血压、稀释血液等常规治疗,对照组给予尼莫地平静脉滴注,观察组给予经导引导管颅内注入尼莫地平治疗,7 d后改口服,疗程7 d。比较两组解痉所需时间、治疗前后血压、临床疗效及格拉斯哥预后量表(GOS)分级。结果观察组解痉所需时间短于对照组(P<0.05)。治疗后,对照组血压显著降低,并且低于观察组(P<0.05),观察组治疗前后血压比较,差异无统计学意义(P>0.05)。观察组疗效及GOS分级优于对照组(P<0.05)。结论经导引导管持续注入尼莫地平治疗颅内动脉瘤栓塞术并发CVS效果好,可缩短解痉时间。
Objective To explore the efficacy of continuous trans-guiding catheter infusion with nimodipine for the treatment of cerebral vascular spasm （ CVS ） caused by intracranial aneurysm embolization. Methods Sixty patients with subarachnoid hemorrhage suffered from CVS caused by intraeranial aneurysm embolization and were randomly divided into control group （ n = 30 ） and observation group （ n = 30）. The routine therapy including volume resuscitation, blood pressure elevation and hemodilution was performed in both groups. The control group was treated by intravenous drip with nimodipine, and the observation group was treated by trans-guiding catheter intracranial infusion with nimodipine. And after 7 days, oral administration with nimodipine was performed in both groups for 7 days. The time for spasmolysis, blood pressure before and after treatment, clinical efficacy and Glasgow Outcome Scale （GOS） grading were compared between the two groups. Results The time for spasmolysis in the observation group was shorted than that in the control group（ P 〈 0.05 ）. After treatment,the blood pressure of the control group decreased significantly and was lower than that of the observation group（ P 〈 0.05 ）. But there was no significant difference between the blood pressure before and after treatment in the observation group（P 〉 0.05 ）. The clinical efficacy and GOS grading of the observation group were superior to those of the control group （ P 〈 0. 05 ）. Conclusion Continuous trans-guiding catheter infusion with nimodipine obtains a good efficacy for CVS caused by intracranial aneurysm embolization, and can shorten the time for spasmolysis.
出处
《广西医学》
CAS
2016年第8期1072-1074,共3页
Guangxi Medical Journal
基金
广西贵港市科学研究与技术开发计划(贵科攻1305010)
关键词
蛛网膜下腔出血
脑血管痉挛
颅内动脉瘤栓塞术
尼莫地平
导管注入
并发症
Subarachnoid hemorrhage, Cerebral vascular spasm, Intracranial aneurysm embolization, Nimodipine, Catheter infusion, Complication
