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
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篇名: 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
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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(P<0.05)。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(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。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 effects of nimodipine and fasudil assisted with early hyperbaric oxygen on the related indicators of patients with cerebral vasospasm after intracranial aneurysm embolism surgery. METHODS: 150 patients with cerebral vasospasm after intracranial aneurysm embolism surgery were randomly divided into control group (75 cases) and observation group (75 cases). All patients received early hyperbaric oxygen, once a day, 7-d was a treatment course, it lasted 3 courses. Based on it, control group received Nimodipine injection 10 mg, adding into 0.9% Sodium chloride injection 100 ml by micropump continuous infusion, q8 h. Observation group was additionally given Fasudil hydrochloride injection 30 mg, adding into 5% Glucose injection 40 ml by micropump continuous infusion, q8 h. They were treated for 3 weeks. Glasgow, MCA, NFI score, Barthel index score before and after treatment, GOS, postoperative 30 d cerebral infarction and the incidence of adverse reactions in 2 groups were observed. RESULTS: After treatment, Glasgow coma score, MCA mean flow velocity, NFI score and Barthel index score in 2 groups were significantly higher than before, and observation group was higher than control group, with statistical significances (P<0.05). Postoperative GOS rating cases in observation group was significantly superior to control group, the incidence of cerebral infarction was significantly lower than control group, with statistical significances (P<0.05); and there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS: Nimodipine and fasudil assisted with early hyperbaric oxygen can effectively reduce the neurological impairment in the treatment of cerebral vasospasm after intracranial aneurysm embolism surgery, accelerate cerebral blood flow velocity and improve life quality, and do not increase the incidence of adverse reactions.
期刊: 2016年第27卷第33期
作者: 张茂,陈健龙,彭浩,符传艺,符策锐
AUTHORS: ZHANG Mao,CHEN Jianlong,PENG Hao,FU Chuanyi,FU Cerui
关键字: 尼莫地平;法舒地尔;高压氧;脑动脉瘤栓塞术;脑血管痉挛 ;疗效;安全性
KEYWORDS: Nimodipine; Fasudil; Hyperbaric oxygen; Intracranial aneurysm embolism surgery; Cerebral vasospasm; Efficacy; Safety
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