静脉滴注尼莫地平时颅内压早期改变的观察

Changes of the intracranial pressure during nimotop infusion

目的：探讨静脉应用尼莫地平（商品名：尼莫通）注射液对神经系统疾病患者颅内压的即时影响。方法：神经内科患者２２例，分为尼莫地平治疗组和对照组各１１例，常规行腰椎穿刺术，在监测腰池脑脊液压力下，治疗组给予尼莫地平加等渗盐水静脉滴注，对照组单独应用等渗盐水。记录输液前、后３０ｍｉｎ的腰池脑脊液压力。统计两组输液前后脑脊液压力差。结果：两组患者静脉输液３０ｍｉｎ后腰池脑脊液压力均有轻度升高，尼莫地平治疗组脑脊液压力升高为（０．１２±０．１１）ｋＰａ，明显低于对照组（０．２６±０．２０）ｋＰａ，两组相比有统计学差异（Ｐ＜０．０５）。结论：尼莫地平于静脉滴注时不会引起神经系统疾病患者的颅内压升高，相反能部分缓解因输液导致的颅内压的暂时性升高，因而临床应用是安全的。

Objectives: To observe changes of intracranial pressure (ICP) of patients with neurological diseases during intravenous infusion of nimotop. Methods : Twentytwo patients with neurological diseases were divided into nimotop group and control group,ICP was monitored by lumber puncture. Nimotop group received nimotop by intravenous infusion, control group received normal saline only. ICP was recorded before and 30 minutes after the infusion. Changes of ICP between the two groups were compared. Results: Means of ICP elevated in both groups 30 minutes after the fluid infusion, but the changes of nimotop group was not as high as control group. The elevation in nimotop group was (0.120.11)kPa and the control group was(0.26 0.20) kPa, the difference was significant statistically (P=0.026). Adult s ICP consists of brain tissue, cerebral blood flow (CBF) and cerebral spinal fluid (CSF). When normal saline was infused intravenously, it might increase CBF as well as increase ICP. When nimotop was infused intravenously, it might decrease the central venous pressure as well as increase the cerebral blood flow. So it helped the absorption of CSF and reduced the transient elevation of ICP by the fluid infusion. Conclusions: Nimotop infusion did not increase ICP in patients with neurological diseases, and it could even reduce the transient elevation of ICP after fluid infusion. Nimotop is safe in neurologic clinics.