尼莫地平加脑脊液置换对蛛网膜下腔出血脑血管痉挛的疗效观察

Effect of nimodipine and cerebrospinal fluid replacement on cerebral vessels spasm after subarachnoid hemorrhage

目的探讨尼莫地平或罂粟碱静脉输注加脑脊液置换治疗自发性蛛网膜下腔出血(SAH)脑血管痉挛的效果。方法以HUNT-HESS分级系统对SAH分级,单用尼莫地平持续泵入或罂粟碱静脉输注治疗19例,在上述治疗的基础上同时脑脊液置换治疗30例,观察指标为临床表现及影像学所见,如DSA、CT及脑电图。结果单用尼莫地平或罂粟碱治疗的19例病人,与采用尼莫地平或罂粟碱加脑脊液置换治疗的效果比较,差异有统计学意义,后者优于前者。结论尼莫地平或罂粟碱静脉输注加用脑脊液置换是治疗SAH后脑血管痉挛的有效方法。

Objective To explore the treatment strategy for cerebral vessels spasm second to subarachnoid hemorrhage （SAH） . Methods To grade for 49 cases of patients with SAH ,in which Nimodipine or Papaverine continuously was applied to pump for 19 cases, permutating cerebrospinal fluid accompanied with the aboved treatment for 30 cases. The indexes were clinical situation and findings by screenage examination, such as DSA , CT and EEG. Results The treeatment of accompaning the permutating cerebrospinal fluid with nimodipine or papaverine was significantly excellent to aplying nimodipine or papaverine alone. Conclusion Accompaning the permutating cerebrospinal fluid with Nimodipine or Papaverine was a kind of effective treatment for cerebral vessels spasm second to SAH.