尼莫地平对锥颅血肿抽吸术后病灶周围水肿的影响

The effect of Nimodipine on perilesional edema in patients with intracranial hemorrhage after minimally-invasive aspiration

目的观察高血压性脑出血(HICH)患者行锥颅血肿抽吸术后尼莫地平对病灶周围水肿面积及神经功能的影响。方法高血压脑出血患者58例,被随机分为治疗组30例,对照组28例。两组患者均采用颅内血肿锥颅抽吸术及脱水、止血、抗炎、控制血压等治疗。治疗组在此基础上加用尼莫地平,10mg/d静脉滴注,15d为1疗程。观察两组患者第7天、第15天与第1天病灶周围水肿面积及神经功能缺失评分之差。结果治疗组、对照组第1天与第7天病灶周围水肿面积之差分别为(1.01±0.06)cm2、(0.01±0.03)cm2,两组比较差异有显著意义(P<0.01);两组第1天与第15天病灶周围水肿面积之差为(1.87±0.11)cm2、(0.60±0.08)cm2,神经功能缺失评分之差为(7.24±0.23)分、(2.67±0.31)分,两组比较差异均有显著意义(P<0.01)。结论尼莫地平能明显减小锥颅血肿抽吸术后病灶周围水肿面积,使神经功能恢复水平进一步提高。

Objective To observe the effect of Nimodipine on perilesional edema and neurological function in patients with hypertensive cerebral hemorrhage after minimally-invasive aspiration. ~Methods 58 cases were randomly divided into two groups, 30 in therapeutic group and 28 in control group. all of the patients received minimally-invasive aspiration, dehydration, hemostasis, anti-inflammation and control of blood pressure. The therapeutic group were treated with Nimodipine 10 mg/ d for 15 days. The differences of the perilesional edema and Chinese Stroke Scale scores between the two groups at the 1st, 7th and 15th day were observed. Results The areas of perilesional edema in therapeutic group decreased(1.01 ± 0.06)cm2 and(1.87 ± 0.11)cm2 after treated for 7 and 15 days, while the areas were(0.01 ± 0.03)cm2 and(0.60 ± 0.08)cm2 in the control group respectively(P < 0.01). The difference of the Chinese Stroke Scale scores at 1st and 15th days was 7.24 ± 0.23 in the therapeutic group, while ~2.67 ± 0.31 in the controls(P < 0.01). No expanding of haematoma and rebleeding were found. ~ Conclusion Nimodipine can reduce the perilesional edema area safely and effectively and improve the neurological function in patients with hypertensive cerebral hemorrhage.