脑底池连续泵输注罂粟碱防治动脉瘤术后血管痉挛

Efficacy of continuous papaverine infusion into the subarachnoid cavity on preventing cerebral vasospasm in patients after aneurism operation

目的 探索脑底池连续泵输注罂粟碱对脑动脉瘤破裂早期手术后的血管痉挛的防治作用 ,以提高手术治疗效果及患者生存质量。方法 对 13例经头颅CT三维血管成像和全脑血管造影检查诊断为脑动脉瘤破裂伴SAH患者 ,行早期急诊手术开颅脑动脉瘤颈夹闭 ,用PCA泵脑底池连续输注罂粟碱 ,经腰大池引流脑脊液 ,直至罂粟碱输注治疗结束。同时观察脑血管痉挛临床五项指征。结果 13例患者输注罂粟碱 8d的11例 ,10d的 2例。患者全部存活 ,术后无脑血管痉挛和不良反应。结论 脑底池连续输注罂粟碱防治脑动脉瘤破裂、蛛网膜下腔出血术后血管痉挛 ,效果确切 。

Objective To find a new way for preventing cerebral vasospasm in patients after aneurysm operation,and to improve curative effect .Methods 13 patients with cerebral aneunysm were diagnosed by CT scans and angiography. All of them were treated with emergency operation.Patients' controled analgesia pump was used to inject 0.12% papaverine 50ml to the subarachnoid cavity each day. At the same time, CSF was drained by lumbar puncture until the end of injection of papaverine.Clinical indexes of cerebral vasospasm were recorded.Results 11 patients were treated with papaverine for 8 days after operation, and 2 patients were treated for 10 days. All patients were alive without cerebral vasospasm or side effects.Conclusion Papaverine infusion into the subarachnoid cavity in patients after aneurysm operation can prevent cerebral vasospasm effectively and safely.